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Breastfeeding

Breastfeeding is a skill that is partly instinctive and partly learnt; there are lots of different positions for breastfeeding. You just need to check the following points no matter which position you choose to feed in.

Before baby goes onto the breast there are a few things to check that will:

  1. Help baby feed well                                
  2. Prevent sore nipples                       
  3. Ensure a good future milk supply

Why not check if

  • You are in a comfortable position that you can sustain throughout the feed? If sitting, supporting your back, using foot rests and sitting upright can aid your comfort.
  • Your breast is unrestricted and able to fall naturally?
  • You are holding your baby close to you? This helps your baby feel more settled and they will not have strain to reach your breast.
  • You are holding baby so that their head and body are in one straight line, so that their head is not twisted?  Even if the head is turned a little it makes swallowing and feeding difficult for baby.
  • You are holding your baby supporting its neck so that its head is completely free to tilt back as baby comes to the breast?
  • Your baby is facing the breast with its nose opposite the nipple? As your baby comes to the breast it will      automatically tip its head back.

Bringing the baby to the breast

  • Wait for your baby to open its mouth really wide, with the tongue down (not crying, as babies tongue will be lifted).
  • Bring the baby swiftly to the breast aiming your nipple at the roof of your baby’s mouth.
  • Baby’s chin and lower lip that will be first to touch the breast about 3-4cm below the bud of your nipple. 
  • Brought to the breast in this way your baby will be able to scoop a large mouthful of breast tissue into it’s mouth.

Things you can check that will reassure you baby is on the breast correctly

  • After the first few sucks it should not be painful (If it is, slide your finger into the corner of babies mouth to break the seal and take baby off and start again).
  • Your baby has a wide open mouth and its chin is firmly touching your breast.
  • Your baby’s cheeks stay full and rounded during sucking because they have a big mouthful of breast tissue.
  • After a period of rapid sucking your baby will settle into rhythmic deep sucking pattern with pauses.  As your baby goes through the feed it is normal for the sucking to become shallower and the pauses to get longer.
  • Allow your baby to finish feeding and come off by its own accord. The consistency of the milk changes through a feed and it is the end of the feed that is very rich in fat, proteins and antibodies.

How to tell if breastfeeding is going well or not

Going well if: Talk to your midwife:
Your baby has 8 feeds or more in 24 hours Your baby is sleepy & has had less than 6 feeds in 24 hours
Your baby is feeding for between 5 and 30 minutes at each feed Your baby consistently feeds for 5 minutes or less at each feed
  Your baby consistently feeds for longer than 40 minutes at each feed
  Your baby always falls asleep on the breast &/0r never finishes the feed himself
Your baby has normal skin colour Your baby appears jaundice (yellow discoloration of the skin)
Your baby is generally calm and relaxed whilst feeding and is content after most feeds Your baby comes on and off the breast frequently during the feed or refuses to breastfeed
Your baby has wet & dirty nappies (see chart below) Your baby is not having the wet & dirty nappies explained below
Breastfeeding is comfortable You are having pain in your breasts or nipples, which doesn’t disappear after the baby’s first few sucks. Your nipples come out of the baby’s mouth looking pinched or flattened on one side
When your baby is 3-4 days old & beyond you should be able to hear your baby swallowing frequently during the feed You cannot tell if your baby is swallowing any milk when you baby is 3-4 days old and beyond
  You think your baby needs a dummy
  You feel you need to give your baby formula milk

 

Most jaundice in babies is not harmful; however, it is important to check your baby for any signs of yellow colouring particularly during the first week of life.  The yellow colour will usually appear around the face and forehead first, then spread to the body, arms and legs.  A good time to check is when you are changing a nappy or clothes.  From time to time press your baby’s skin gently to see if you can see a yellow tinge developing.  Also check the whites of your baby’s eyes when they are open and the inside of his/her mouth when open to see if the sides, gums or roof of the mouth looks yellow.

Nappies

The content of you baby's nappies will change during the first weeks. These changes will help you know if feeding is going well. Speak to your midwife if you have any concern.

  Wet nappies Dirty nappies
1-2 days old 1-2 or more per day, urates may be present* 1 or more darkgreen/black 'tar like', called 'meconium'
3-4 days old 3 or more per day, nappies feeling heavier 2 or more, changing in colour & consistency - brown/green/yellow, becoming looser, called 'changing stools'
5-6 days old 5 or more, heavy wet** 2 or more yellow; may be quite watery
7-29 days old 6 or more, heavy wet 2 or more at least the size of a £2 coin yellow and watery, 'seedy' appearance.

 

* Urates are dark pink/red substances that many babies pass in the first couple of days.  At this age they are not a problem, however if they go beyond the first couple of days you should tell your midwife as that may be a sign that your baby is not getting enough milk

* * With new disposable nappies it is often hard to tell if they are wet, so to get an idea if there is enough urine, take a nappy and add 2-4 table spoons of water.  This will give you an idea of what to look/feel for.

Adapted from UNICEF UK Baby Friendly Initiative 2008.

Some more tips and information

If breastfeeding feels a bit awkward at first, don’t worry. You and your baby may just need a little more practice. Breastfeeding is a skill that you and your baby learn together, and it can take time to get used to.

  • Have you had a look at the leaflet "Off to the best start" you have been given before going home?
  • Have you tried the Breastfeeding Support and drop-ins in your local area?
  • Any help from the links listed below?
  • Have you asked your Community Midwife? Or, if out of hours, the Maternity Bleep Holder via Kingston Maternity Switch 0208 546 7711 then bleep 552.

Useful links 

Baby Friendly Initiative, UNICEF

Breast massage - video

Breastfeeding problems 

 La Leche League GB

on 0300 100 0212, lines open 9.30am – 9.30 pm 365 days a year.

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