What to expect when you're expecting (173 page)

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Authors: Heidi Murkoff,Sharon Mazel

Tags: #Health & Fitness, #Postnatal care, #General, #Family & Relationships, #Pregnancy & Childbirth, #Pregnancy, #Childbirth, #Prenatal care

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Getting Started Breastfeeding

There’s nothing more natural than nursing a baby, right? Well, not always, at least not right away. Babies are born to nurse, but they’re not necessarily born knowing how to nurse. Ditto for moms. The breasts are standard issue, they fill with milk automatically, but knowing how to position them effectively in baby’s mouth, well, that’s a learned art.

Truth is, while breastfeeding is a natural process, it’s a natural process that doesn’t necessarily come naturally—or quickly—to some mothers and babies. Sometimes there are physical factors that foil those first few attempts; at other times it’s just a simple lack of experience on the part of both participants. But whatever might be keeping your baby and your breasts apart, it won’t be long before they’re in perfect sync. Some of the most mutually satisfying breast-baby relationships begin with several days—or even weeks—of fumbling, bungled efforts, and tears on both sides.

Learning as much as you can about breastfeeding ahead of time—including how to deal with those inevitable setbacks—can help speed that mutual adjustment. Doing lots of reading up or even taking a prenatal class in breastfeeding will be invaluable, as will the following:

Get off to an early start. Right in the birthing room is ideal, if that’s possible (see Breastfeeding Basics for a how-to,
page 438
.) Let your practitioner know that you’d like to begin breastfeeding as soon after delivery as you can (and while you’re at it, write down that request in your birth plan, if you’re using one). Don’t be disappointed if either you or baby (or both of you) isn’t up to nursing right away. That doesn’t mean you won’t be able to start successfully later. And keep in mind that even the earliest of starts won’t guarantee a smooth first nursing experience. You both have a lot to learn.

Keep the nursing team together. Arrange for full or partial rooming-in, if you feel up to it, so you’ll be ready to nurse when baby’s ready. If you’d rather rest between feedings—you’ve earned it—ask for a demand-feeding schedule (your baby will be brought to you when he or she is hungry).

Enlist as much help as you can. Ideally, a lactation specialist will join you during at least a couple of your first baby feedings to provide hands-on instruction, helpful hints, and perhaps some reading materials. If this service isn’t offered to you, ask if a lactation consultant or a nurse who is knowledgeable about breastfeeding can observe your technique and redirect you if you and your baby aren’t on target. If you leave the hospital or birthing center before getting this help, your technique should be evaluated by someone with breastfeeding expertise—the baby’s doctor, a home nurse, or an outside lactation consultant—within a few days. You can also find empathy, advice, and referrals to lactation consultants by calling your local La Leche League chapter. Or contact the International Lactation Consultant Association (ILCA), (919) 861-5577, ilca.org, for a lactation consultant in your area.

Don’t let well-wishers get in the way. Consider limiting visitors (maybe even to just your spouse) while you and baby are getting the hang of breastfeeding. As anxious as you are to show your new arrival off, you’ll need to maintain a relaxed atmosphere—and complete concentration—during those learning-to-nurse sessions.

Be patient if your baby gets off to a slow start. He or she may be just as tuckered out from delivery as you are, maybe even more so. Newborn babies are sleepy babies, and yours is likely to be especially drowsy and sluggish at the breast if you received anesthesia or had a prolonged, difficult labor. That’s no problem because newborns need little nourishment during the first few days of life. By the time your baby starts needing some serious chow, he or she will be ready to do some serious chowing down. What babies do need even early on, though, is nurturing. Cuddling at the breast is just as important as suckling.

Keep your baby bottle-free. Make sure your baby’s appetite and sucking instinct aren’t sabotaged between nursings by well-meaning nurses wielding bottles of formula or sugar water. First, because it doesn’t take much to satisfy a newborn’s tender appetite. If your baby is given even a small supplementary feeding in the nursery, he or she will be too full for your breast when it’s time to nurse. If your baby doesn’t nurse, your breasts won’t be stimulated to produce milk, and a vicious cycle—one that interferes with the establishment of a good demand-and-supply system—can begin. Second, because a rubber nipple requires less effort, your baby’s sucking reflex may become lazy when a bottle’s offered. Faced with the greater challenge of tackling the breast, baby may just give up. Pacifiers might also interfere with nursing (though not in all cases). So issue orders—through your baby’s doctor—that, as recommended by the American Academy of Pediatrics, supplementary feedings and pacifiers should not be given to your baby in the nursery unless medically necessary.

Nurse on demand. And if the demand isn’t there yet, nurse frequently anyway, getting in at least 8 to 12 feedings a day. Not only will this keep your baby happy, it will stimulate milk production and increase your milk supply to meet his or her growing demand. Imposing a four-hour feeding schedule, on the other hand, can worsen breast engorgement early on and result in a baby who’s not getting enough to eat later.

Nurse without limits. It used to be thought that keeping initial feedings short (five minutes on each breast) would prevent sore nipples by toughening them up gradually. Sore nipples, however, result from improper positioning of the baby on the breast and have little to do with the length of the feeding. Most newborns require 10 to 45 minutes to complete a feeding (it’s not as easy as it looks). As long as your positioning is correct, there’s no need to put time limits on nursing sessions.

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