Breastfeeding Your Baby
How it's done, positioning and attachment, one side or tw, how to express and more

Health benefits of breastfeeding to you and your baby
Breastfeeding protects your baby's health, not just now, but later on. Research shows that the benefits can last into toddlerhood and childhood. Breastmilk builds immunity to infection, and aids the proper development of the brain. Breastfeeding reduces the risk of:

• gastro-enteritis — vomiting and diarrhea
• ear infections
• wheeze when breathing/asthma
• eczema, where this runs in the family
• developing diabetes in childhood
• urinary infections
• chest infections.

Breastmilk has a special value for pre-term babies who are vulnerable to some very dangerous conditions and infections.  Mothers who breastfeed have a reduced risk of:

• ovarian cancer
• pre-menopausal breast cancer.

You can help to get breastfeeding off to a good start by holding your baby in skin to skin contact after the birth. This helps to calm your baby and regulate his breathing and heart rate. He will enjoy your warmth and closeness, smell and taste. It also stimulates your breastfeeding hormones and encourages your baby to seek your breast for his first breastfeed.

Some mothers prefer just to hold their baby close and see whether he decides to 'help himself'. Although breastfeeding within the first hour after birth is recommended, not all babies are ready for this, for instance, because his natural feeding instincts have been affected by receiving some of your pain-relieving drugs while you were in labour. If this happens just go through the skin to skin contact and first feed when you are both ready a little later on.

This first meeting can be a deeply moving experience, a time to speak softly, stroke your baby and get to know him. However some mothers can feel exhausted and overwhelmed and may wish to delay the experience till they feel ready for it.

Positioning and attachment:

Holding your baby in the correct position and helping him to latch onto your breast are important for effective and pain-free breastfeeding. Your midwife will offer to help you to get these right in the early days. When you and your baby are learning, these points may help.

Hold your baby so that:

• he is held close with his head and body in a straight line
• he is turned in towards your breast
• your nipple points towards his top lip or nostril.

Then when your baby opens his mouth wide, with his tongue down, bring him quickly onto your breast. If he is well attached you might notice that:

• his mouth has a wide angle
• his bottom lip is turned outwards
• his chin is close against your breast
• more of the brown area (areola) shows above than below
• his cheeks are full (not drawn in) whilst feeding
• feeding should not hurt.

If breastfeeding hurts or is not going well it is worthwhile asking your midwife or health visitor to watch whilst you feed to see if your positioning and attachment are right.

How breastfeeding works
Breastfeeding works through demand and supply. The baby's suckling not only stimulates your breast to produce milk for the next feed but also to release or 'let-down' the milk that is already made. The let-down reflex causes tiny muscle cells in the breast to contract so that milk is expelled from deep within your breast, down the ducts to the nipple. Some mothers notice a 'drawing' or 'pins and needles' sensation when this happens, other mothers might not notice anything but a small increase in the rate that milk drips from the opposite breast.

Babies can vary in how long and often they breastfeed. Letting your baby feed as often, and for as long as he needs to, will help to ensure enough milk is made and that he has enough time to have a satisfying feed. In the early weeks this may be as often as 6 to 12 feeds in 24 hours.

Changes in the early days and weeks.
Breastmilk adapts to your baby's needs as he grows. The first milk produced in your breast in late pregnancy and in the early days after birth is called colostrum. It is rich in nutrients, protective antibodies and helps to clear your baby's bowel of the first stool. You might notice that your baby's stool changes during those first few days so that by day 5 your baby is likely to have loose, yellow or mustard coloured stools. This is normal and very different from a bottle fed baby's stool.

The chart below depicting the approximate color of your baby's stool should be used a guide only.

Your milk 'comes in' around the 2nd to 5th day depending on your circumstances. As your baby starts to feed at the breast he gets thirst quenching foremilk which changes gradually, as the let-down reflex works, to calorie rich and satisfying hindmilk. (You make only one kind of milk - it is just that the fat cells cling to the storage cells in the breast until the let-down reflex works). Your baby needs both fore and hindmilk so it is important to let your baby come off the breast naturally when he has finished feeding. Taking your baby off the breast before he is ready may mean he has a less satisfying feed than if he is left to decide for himself when he is finished feeding.

One Side or Two?
Let your baby decide whether he needs one breast or two at a feed. Allow him to come off the first side when he is ready then you can offer him the other breast, which he may or may not want. Offer him the unwanted breast first at the next feed.

Here's how to express
Expressing means removing milk from the breast by hand expressing or by using a breast pump. These pumps are available from many chemists or baby stores. It is a good idea to find out from your midwife, health visitor or breastfeeding counsellor which pumps are most effective and also where you can hire an electric breast pump if you need one, e.g. if your baby is ill or in a special care baby unit.
Your midwife will usually explain how to hand express within the first few days after the birth.

Expressed breastmilk can be stored in a fridge at 2-4 degrees centigrade for 8 days and in the deep freezer for 3 to 6 months. Milk should be frozen in small quantities — ice-cube trays are suitable — to make defrosting easier and to enable you to vary the amounts you defrost more easily. Wash your hands before expressing and sterilise any containers you use.