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Why Breasts Need Care During Pregnancy

Your breasts begin preparing to nourish your baby almost from day one of your pregnancy. In the early days you probably noticed they were extra swollen and sensitive. Their increasing size during your first trimester is caused by the development of the milk-making structures within them. Your blood flow increases and veins along with stretch marks may become visible.

Your nipples and areola (area around the nipple) may double in size and deepen in color. This darkening helps a newborn zero in on your nipple for feeding. The small glands located in the areola will become more pronounces. This is important because these tubercles secrete an antibacterial lubricant that keeps the nipple moist and protected during pregnancy and breastfeeding. Be extra careful not to use a soap or cream that could remove the breasts’ natural lubricant and antibacterial functions.

By your fifth or sixth month, your breasts are ready to produce milk. Some women may notice drops of fluid on their nipple. This fluid is colostrum and will be your baby’s first food in the first days after delivery.

Why Breastfeeding Moms Need a Nursing Bra

After delivery when your milk production kicks in, your breasts will fill up with milk making them heavy and in need of supportive care. A good bra supports the ligaments in and around your breasts as they work to hold up the extra weight of your fuller, heavier breasts. Good support now will hopefully minimize breast sag later.

A nursing bra is designed with flaps or panels to easily open and provide your baby access to your breasts without having to remove your entire bra.

Tips for Choosing a Nursing Bra

Your nursing bra should be supportive but not tight. It should not leave any indentations or marks on your skin. If your bra is too tight, it could cause plugged milk ducts, mastitis or a decrease in your milk supply. Take a new measurement or have a bra specialist at your favorite lingerie or maternity store do it for you. They can also help with a bra fitting and help you choose the right bra.

A soft cup bra is preferred over an underwire bra. The wire from an underwire bra can put pressure on the tissue at the base of your breast leading to the same problems that a tight bra can cause.

Choose a bra that is made from cotton or other natural materials. Natural materials are absorbent and allow air to flow to your breasts. Synthetic materials can irritate your breasts and trap moisture.

Pick a bra that has flaps you can operate with one hand so that you can easily open and close while holding your baby. Ensure there is room for a breast pad in case you experience leaks.

It may be helpful to have at least two nursing bras so that you can wear one while the other one is in the wash. Change your bra whenever it becomes dirty or wet since moisture laying on your breasts for an extended amount of time can result in skin irritation, sore nipples, mastitis or thrush. Nursing pads or breast shells worn inside your bra can also help to keep your bra clean and dry.

Want to Know More?

Changes in Your Body

Labor and Birth

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Weaning a Baby Under 12 Months

Substitute their least favorite feeding first. If baby won’t accept the bottle from you, try having a support person offer the bottle. It may be helpful if you’re not around for baby to see or smell you. Otherwise they’ll hold out for your breast. Give baby have a day or two between substitute feedings with a bottle.

If you become engorged, pump or express a little milk from your breasts and store it. But don’t express a whole feeding’s worth of milk, just enough to take the pressure off and be comfortable. Your body will soon get the signal to make less milk over time.

Weaning an Older Child

If breastfeeding is going well, you and baby may not be in a hurry to start weaning. Just know that an older baby may resist being taught the new and challenging skill of chewing and swallowing solid foods. Breastfeeding or bottle-feeding is so much easier, plus they’re used to the taste of your breastmilk.

When baby is six-months or older, you can try offering purees of banana, carrots, or ripe avocados. Once those foods are well-received, try offering them in manageable sizes, e.g. pea-size for firmer items and marble-size for softer foods.

Introducing Solid Foods

When you add solid foods to your baby’s diet, continue breastfeeding until at least 12 months old. You can continue to breastfeed after 12 months if you and your baby desire. Check with your child’s doctor about vitamin D and iron supplements during the first year.

Parents with food allergies are advised to avoid foods that commonly cause allergic reactions (cow’s milk, dairy products, and foods made from peanuts or other nuts). But recent research found that the late introduction of certain foods may actually increase your baby’s risk for food allergies and inhaled allergies. You should discuss any concerns with your pediatrician.

If no allergies are present, simply watch your baby for indications that they are interested in trying new foods and then introduce them gradually, one by one. Signs that the older baby is ready for solids include sitting up with minimal support, showing good head control, trying to grab food off your plate, or turning their head to refuse food when they’re not hungry. Your baby may be ready for solids if they continue to act hungry after breastfeeding. The loss of the tongue thrusting reflex that causes food to be pushed out of their mouth is another indication they’re ready to expand their taste experience.

First foods

Here are good first foods to start with:

Iron-fortified infant cereal (such as rice or oatmeal) is a good solid food to complement breast milk. When first starting infant cereal, check the label to make sure it’s a single- ingredient product—just rice or oatmeal, and does not contain added fruit, milk or infant formula. This will reduce any potential allergic reaction with the initial cereal feedings. You can mix the cereal with your breast milk, water, or formula (if you’ve already introduced formula to your baby) until it is a thin consistency. As your baby gets used to the taste and texture, you can gradually make it thicker and increase the amount.

Vegetables. Start with milder yellow or orange options such as sweet potatoes and carrots before moving on to stronger flavors like peas and string beans.

Fruit. Easy-to-digest first fruits include finely mashed bananas, baby applesauce, peaches and pears. Mashed or pureed ripe avocado is yummy and loaded with healthy fats.

Since most breastfeeding babies’ iron stores begin to diminish around six months, good first choices for solids are those rich in iron. Current recommendations are minced meats, such as turkey, chicken, and beef. Meats are good sources of high-quality protein, iron, and zinc and provide greater nutritional value than cereals, fruits, or vegetables.

Feeding Tips

Introduce only one new food at a time and wait several days before you add another new food, to make sure baby does not have a negative reaction.

Try, try again. If baby rejects what you offer, try again tomorrow and the next day and the next. Some babies need to be introduced to a new food a dozen times before they’ll accept it. Be patient.

Be a good eater model. Babies who see adults eating good food and enjoying it are more likely to be interested in following their example.

It’s always in the timing. The “perfect” time of day to feed your baby is whatever time works for both of you. If you’re breastfeeding, you might try solids when your milk supply is at its lowest (late afternoon or early evening). You can experiment. Offer a first course of formula or breast milk to whet that appetite, then bring on the solids. Start with one meal per day, then move up to two (probably a morning and evening meal) for the next month or so.

In the mood. When baby is cheerful and alert, they’re more likely to open wide for an incoming spoon. If baby is fussy or getting sleepy, they may want only breast (or bottle). If your baby is fussy, be flexible — you might want to skip solids at that meal and try them next time.

Patience and more patience. It takes time and practice for both of you to master feeding solids. So give yourself and baby plenty of time for feedings.

Practice with the new tools. Before baby actually takes that first bite, let them practice sitting in the high chair or feeding seat for a couple of days, adjusting the height of the tray or seat so it fits just right. Babies are wiggly so always fasten the safety straps, including the one around the crotch. If baby can’t sit up at all in such a chair or seat, you should postpone solids until they can.

Bowls and cups. Silicone or plastic ones with a small, soft bowl are much easier on tender gums. Have several on hand during feedings – one for you, one for baby and a spare when one lands on the floor. A bib now means less resistance later.

Before even attempting to spoon feed, put a dab of the food on the high chair tray and give baby a chance to examine it, squish it, mash it, rub it and maybe even taste it. That way, when you do approach with the spoon, what you’re offering won’t be unfamiliar.

Easy does it. Solids are really different, with new tastes, textures and smells so go easy. Start by gently placing about a quarter teaspoon of food on the tip of baby’s tongue. If that’s swallowed, try another quarter teaspoon. At first, expect almost as much food to come in as goes out. Eventually your little one will get the hang of spoon-feeding and respond mouth-open.

Monkey see, monkey do. It’s an old parent trick but a goodie: Open up wide and take a pretend taste from the spoon and smack your lips and show how tasty and fun the food is.

Enough is enough. Knowing when it’s time to stop feeding is as important as knowing when to start. A turned head or a clenched mouth are sure signs that baby is finished with this meal. Forcing a baby to eat is always a lost cause and can actually set up future food fights.

Don’t be upset or mad if most of what you serve baby ends up on the floor or goes uneaten. Your baby’s first experiments with food are more about gaining experience than gaining sustenance. The bulk of your child’s nutritional needs for the first year are still going to be met by breast milk or formula.

Some pediatricians recommend an iron supplement. If this is the case, be careful to give the exact dose prescribed by your doctor. Always store iron and vitamin preparations out of the reach of young children in the household, since overdoses can be toxic.

When a Child Isn’t Ready to Wean

If weaning is going too quickly for your child, they’ll let you know by their behavior. Increased tantrums, new fear of separation and clinginess are possible signs that weaning is going too quickly. Illness and teething can also interfere with weaning and it might be necessary to take a break.

Weaning does not need to be all or nothing. You can do it gradually and blend breastfeeding and foods as long as you and your baby desire.

Want to Know More?

• Is Green Baby Poop Normal?
• How to Burp Your Baby
• How to Ensure Safe Sleep for  Your Baby

SOURCES
U.S. Dietary Guidelines for Americans
The American Academy of Pediatrics: New Mother’s Guide to Breastfeeding.
La Leche League International

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What causes a low breast milk supply?

Various factors can cause a low milk supply during breastfeeding: waiting too long to start breastfeeding, not breastfeeding often enough, an improper latch and use of certain medications. Sometimes previous breast surgery can affect milk production.

Other factors that can affect milk production include:

• Premature birth
• Maternal obesity
• Pregnancy-induced high blood pressure
• Poorly controlled insulin-dependent diabetes

Milk production tips:

Breastfeed as soon as possible. This is the key to successful long-term breastfeeding. Waiting too long to start is the primary contributor to a low milk supply. Hold your baby skin to skin right after birth and your baby will likely breast-feed within the first hour after delivery. If not, hand express and feed the colostrum with a teaspoon.

Breastfeed often. Aim for at least eight to 12 feedings a day — about every two to three hours. Don’t wait for baby to cry or fuss to offer the breast. Feed when baby is active and alert. If baby is sleepy, try tickling feed and switching breasts or positions often.

Proper latch. Make sure your baby is latched on and positioned well. Tummy to tummy and nipple to nose are good positioning. Look for signs that your baby is swallowing. If baby is just sucking but not swallowing, you can make milk flow by gently squeezing your breasts.

Empty to make more. Emptying each breast more fully at every feeding makes more milk.

Be alert to feeding problems. Offer both breasts at each feeding. If baby nurses only one breast at a feeding, you need to pump or hand express the other breast to relieve pressure and protect your milk supply.

Don’t skip breastfeeding sessions. Pump or hand express your breasts if you miss a breastfeeding session. This helps protect your milk supply.

Hold the pacifier. If you choose to give your baby a pacifier, consider waiting until three or four weeks after birth. This will give you time to establish your milk supply.

Use medications with caution. Certain medications decrease milk supply, including medications containing pseudoephedrine (Sudafed, Zyrtec D, others). Hormonal birth control (pills, rings, patches, etc.) should be avoided until breastfeeding is firmly established.

Avoid alcohol and nicotine. Drinking alcohol and smoking will decrease milk production.

Maintaining your milk supply during breastfeeding is important for your baby’s health and growth.

If you’re concerned about your milk supply or your baby’s feedings, talk to your doctor, pediatrician or a lactation consultant.

Learn More

Boosting Your Breast Milk Supply With Galactagogues

Breastfeeding Nutrition

Resources:

Mayo Clinic: Low Milk Supply: What Causes It?

La Leche League International: Increasing Milk Supply poster

The post Increase Your Breast Milk Supply appeared first on American Pregnancy Association.

• It helps stimulate your breast milk production which increases your supply
• It’s an easy, immediate way to relieve engorged breasts
• It’s convenient and free

Prepare for Hand Expression

• Wash your hands.
• Ready a clean container to collect your milk; colostrum can be expressed into a small (5ml) container or even onto a teaspoon if you want to feed it to your baby immediately.
• Relax and get comfortable (privacy will help too). Take some deep breaths and drop your shoulders, relax and visualize flowing milk. It can be easier to get your milk flowing if your baby is nearby. – if he is not try thinking about him, or looking at a photo or recording of him.

How to Hand Press Breast Milk

• Gently massage your breasts with your hands and fingertips to stimulate your milk ejection reflex – this is the key to effective hand expressing.
• Hold your breast with your fingers and thumb cupped around your breast in a C shape, near but not touching your areola.
• Press your fingers and thumb back towards your chest.
• Compress your breast between your fingers and thumb, moving them slightly towards your nipple without lifting them from your breast.
• Release without moving your hand from your breast.
• Repeat, moving your hand to a different place around your breast after every few compressions or whenever milk flow stops, so that you compress all of your milk ducts. Releasing and repeating rhythmically helps to mimic the action of a baby breastfeeding.

Expressing Tips

• Bend forward with your breasts suspended allows gravity to help your milk flow.
• Give yourself plenty of time. Frequent short sessions are usually more effective than infrequent, longer expressing sessions. The whole process may take 20 or 30 minutes, but you can stop and start again later if you need to.

For most moms it’s a process of trial and error. When you get a spray of milk from at least one nipple pore (instead of drops or a dribble), you’ve found what works for you.

The signal to your breasts to make milk happens right after delivery. By hand expressing in these first hours, you’re ensuring a good supply of your future milk. A good supply is key to successful long-term breastfeeding and all the benefits you and your baby will enjoy.

Still unsure? Check out this how-to video from Dr. Jane Morton, pediatrician and director of the Breastfeeding Medicine Program at Stanford Medicine.

Want to Know More?

Breastfeeding Overview

Breastfeeding Challenges

Sources:

• La Leche League International: The Womanly Art of Breastfeeding
• Droplets

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Preparing to introduce the bottle to a breastfed baby

After about four weeks of breastfeeding, begin pumping after one feeding a day where your breasts still feel a little full. The goal is to pump some breast milk “leftovers.” Freeze this first batch immediately and add other leftovers to it after they have cooled in the freezer.

Based on your baby’s weight, you can calculate the total number of ounces your baby takes in each day. If you’re uncertain, ask your pediatrician, doula or lactation consultant to help you calculate.

Once you know baby’s total feeding volume over a 24-hour period, divide that by the typical number of times your baby feeds for a target volume for the first bottle.

Example volume for baby’s first bottle:

• • If  baby takes about 24 ounces a day and feeds between eight and 12 times a day,
  • That means he could take anywhere from 2 to 3 ounces.
  • Pump until you have a 2-ounce bottle and then have several 1/2 ounce bottles ready in case baby is still hungry.

When you have stored enough to equal a typical feeding plus just a little more, you’re ready to introduce a bottle.

• Thaw out the 2-ounce bottle in the refrigerator overnight.
• When it’s close to feeding time, place the bottle from the refrigerator in a bowl of warm water (bath temperature) or a bottle warmer.
• Often it helps to run the bottle nipple under warm water to make it more acceptable to the baby.

Selecting the bottle and nipples

Many babies prefer drinking from certain bottles and nipples; you may need to try a few brands before you discover your baby’s preference. There are many options for nipple size and shape. The flow rate is determined by the size of the hole at the tip of the nipple; the slower flow bottles have a smaller hole. It is best to start with the slow flow (smallest hole).

How to introduce the bottle

To introduce the bottle it’s best to hold baby in an upright, almost sitting position that is similar to your sitting position. Hold the warmed bottle at an angle tilted just enough to fill the nipple. This tilt allows baby to keep control of when and how fast the milk comes.

The first few times your baby drinks from a bottle, ask your partner or another caregiver to hold your baby to do the feeding. If you are holding your baby, it may trigger the habit to breastfeed and make introducing the bottle more difficult.

When baby is finished, you will pump to create a bottle equal to what the baby consumed. Remember that the baby is always better than a pump! If you do not pump as much as the baby took, it is more likely a pump issue than an issue of not enough milk. Just pump after another breastfeeding and add that amount to what you pumped to get the amount baby took.

Begin introducing the bottle 1-2 weeks before you return to work or school. Your baby will need time to learn this new skill, so do a trial run or rehearsal of the new routine. Plan to leave your baby for 1-2 hours before you go back. Head to the grocery store or gym and leave your baby with the chosen caregiver. You can return early if you need to, but this helps you and your baby prepare for the new routine.

Continue breastfeeding as often as you can, and pump only when needed. Nursing your baby stimulates your body to produce more milk, so putting your baby to the breast keeps your milk supply strong.

Want to Know More?

• Breastfeeding vs Bottle Feeding Formula

Compiled from the following References:
Newman, J. (1990). Breastfeeding Problems Associated with the Early Introduction of Bottles and Pacifiers. Journal of Human Lactation, Vol. 6.
Brown, R., (2007). Can Bottle-Feeding Really Mimic Breastfeeding? Journal of Human Lactation Vol 23
Lyford, E., (2011). Bottle-Feeding the Breastfed Baby. Kellymom.com.

La Leche League International.

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The Benefits of Breastfeeding

Research shows breastfed babies have a decreased likelihood for allergies and dental caries. They also benefit from appropriate jaw, teeth and speech development as well as overall facial development. Breastfeeding has been shown to be protective against many illnesses and conditions, including:

• Painful ear infections
• Upper and lower respiratory ailments
• Colds, viruses, staph, strep and e coli infections
• Allergies
• Intestinal disorders
• Type 2 diabetes
• Certain childhood cancers

The Basics of Breastfeeding

Breast milk is produced naturally by women and provides basic nutrition for a baby during the first several months of life. Your breast milk is made to order for your baby and provides the specific nutrients your baby needs to grow, both in size and maturity.

Breast milk has three different and distinct stages: colostrum, transitional milk, and mature milk.

Colostrum is the first stage of breast milk. It occurs during pregnancy and lasts for several days after the birth of the baby. It is either yellowish or creamy in color. It is also much thicker than the milk that is produced later in breastfeeding.

Colostrum is high in protein, fat-soluble vitamins, minerals, and immunoglobulins. Immunoglobulins are antibodies that pass from the mother to the baby and provide passive immunity for the baby. Passive immunity protects the baby from a wide variety of bacterial and viral illnesses. Two to four days after birth, colostrum will be replaced by transitional milk.

Transitional milk occurs after colostrum and lasts for approximately two weeks. The content of transitional milk includes high levels of fat, lactose, and water-soluble vitamins.  It contains more calories than colostrum.

Mature milk is the final milk that is produced. 90% of it is water, which is necessary to keep your infant hydrated. The other 10% is comprised of carbohydrates, proteins, and fats which are necessary for both growth and energy. There are two types of mature milk:

• Fore-milk: This type of milk is found during the beginning of the feeding and contains water, vitamins, and protein.
• Hind-milk: This type of milk occurs after the initial release of milk. It contains higher levels of fat and is necessary for weight gain.

How Do You Know When Baby is Ready to Breastfeed?

Breastfeeding will be easier if you answer baby’s requests instead of waiting for their demands. So be alert for their feeding cues. Once you and your baby are “in-tune” with one  another, baby will know how best to alert you when hungry.

• A baby starts with subtle nursing cues— eyes moving beneath eyelids, eyelids fluttering before they even open, hands coming toward face, mouth movements.
• Then she adds more obvious ones— rooting toward your chest, whimpering or squeaking.
• If you offer to nurse now, she’ll probably take your breast gently and easily.
• As her hunger builds, her body and mouth tense. She breathes fast or starts to cry.
• Once she’s crying, she’ll have a harder time latching. Crying is a late sign of hunger. Calm her down before trying to feed her.
• Don’t wait for your breasts to feel full. A full breast has already started to slow down production.
• Offer even if she’s not asking, anytime you like

How Do You Know Your Baby is Getting Enough Milk?

It’s common for new moms to be concerned about their milk supply. Unlike bottle feeding, you can’t measure the volume of milk your baby drinks when you are exclusively breastfeeding. So how do you know what’s normal? Relax. When it comes to breastfeeding, there is no “normal.” All moms, with rare exceptions, can produce enough breast milk to exclusively breastfeed. Once the kinks are worked out and you and baby have an established feeding routine, breast milk production becomes simply a case of supply and demand. The amount of milk you produce is directly related to the amount of milk your baby drinks at each feeding. That’s because your baby’s nursing stimulates your prolactin – the hormone responsible for producing milk. The more baby nurses, the more prolactin you will produce, and the more milk you will make.

Here are a few clues to note to be sure your baby is eating enough:

Breastfeeding Frequency and Duration: Note the number of feedings per day and how long your baby nurses at each feeding to get an idea of how much your baby is eating. In the first few days after birth, baby will need to nurse frequently, as often as every ½ hour. Most newborns need 10-45 minutes to complete a feeding. Don’t be in a hurry. This is an important time for baby to be nourished and for the two of you to bond.

Diaper Volume: Note how often and how much your baby is urinating. During the first few days of life, baby will wet 1-2 diapers a day. Once your milk comes in around day 3 or 4, you can expect to change 5-6 disposable diapers per day.

Suck Swallow Pattern: Note the quick sucks at the beginning of a feeding, which will stimulate let-down, followed by long, slow sucks with regular swallowing and a breath after every one or two sucks. If you can identify this suck-swallow pattern, then you will know that baby is nursing successfully.

Crying after a Feeding: It is a common myth that crying after a feeding means baby is still hungry. Rule out all possibilities for the distress and rethink offering a bottle as a solution because it can cause nipple confusion and/or decreased milk production.

Sleeping through the night: It’s another common myth that babies will sleep through the night by the time they reach 3 months of age. Encouraging your baby to sleep through the night, because that is what is expected, can have detrimental effects on your milk supply. Plus, sleeping through the night may indicate baby is not getting enough to eat. A baby who sleeps longer than 4 hours more than once or twice in a 24 hour period may be sleeping to conserve calories because he isn’t getting enough to eat.  Babies may need to feed during the night to get in the calories missed during a busy day or due to a period of separation from mom, especially if mom has gone back to work.

Visit with a Lactation Consultant to learn more about breastfeeding and breast milk.

Want to Know More?

• How to Pump Breast Milk
• Breastfeeding Challenges
• When to Introduce the Bottle

Compiled using information from the following sources:

• How Do I Know My Baby is Getting Enough Milk?, by Kelli Bottolfson-Brown, Fairhaven Health
• Olds, London, and Ladewig’s Maternal Newborn Nursing
  Melloni’s Illustrated Dictionary of Obstetrics and Gynecology

The post Breastfeeding Overview appeared first on American Pregnancy Association.

Positioning and Latch

The position in which you hold your baby is crucial so experiment with several and see what works for you and your baby.  When a good position and latch are obtained, your baby feeds efficiently and your nipples stay healthy. Breastfeeding can be a wonderful experience between mother and baby.

Good positioning helps eliminate many cases of sore nipples. But, if you do have soreness, American Pregnancy Association recommends using an all natural, soothing balm.

Recognize Baby’s Hunger Cues

Learn to recognize your baby’s early hunger cues, signaling that he/she is ready to feed.  Early cues include opening his mouth, moving his head side to side, sucking on hands and fingers.  Fidgeting and fussing at this time are also indicators that your baby is hungry but don’t wait for baby to cry. Crying is a late hunger cue and may make it more difficult to begin breastfeeding.

How to Get a Baby to Latch

These techniques plus proper positioning can help ensure a good latch:

• Get in a comfortable chair with great back support to feed your baby. Using a stool to rest your feet on will help with good posture and prevent you from straining your neck and shoulders.
• Use your breastfeeding support pillow if you have one. (And if you don’t, use whatever kind of pillows you can find to help support you and the baby.) A good breastfeeding pillow can make a huge difference in getting the baby in a proper position to latch on well.
• Make sure your baby is tummy-to-tummy with you at all times.
• Make sure you bring your baby to you, do not try to lean into the baby. Not only will this cause severe strain on your neck and shoulders, but it can affect the baby’s position.
• Remember to keep your baby’s ear, shoulder, and hip in alignment, which will make swallowing easier.
• The baby’s nose should be opposite the nipple.
• You might need to hold your breast to help guide the nipple to your baby’s mouth. Grasp the breast on the sides, using either a “C” hold or “U” hold. Make sure to keep fingers far from the nipple so you don’t affect how the baby latches on.
• Aim the nipple toward the baby’s upper lip/nose, not the middle of the mouth. You might need to rub the nipple across the top lip to get your baby to open his/her mouth.
• The baby’s head should be tilted slightly back. You do not want his chin to his chest.
• When he opens his mouth wide with the chin dropped and tongue down, he should latch on to the nipple. If he does not open wide, do not try to shove the nipple in and wiggle the mouth open. It is best to move back, tickle the lip again with the nipple and wait for a wide open mouth.
• Try to get as much of the lower portion of the areola (the area around the nipple) in the baby’s mouth.
• The baby’s chin should indent the lower portion of your breast.
• Look to see if the baby’s bottom and top lip are flanged out like fish lips. If they are not, you may use your finger to pull the bottom one down and open up the top one more.

Positioning your baby to feed

There are many different positions that can work while breastfeeding. It is important to find one that is comfortable for both you and your baby.

Cross-Cradle Hold:

This position is often the most helpful for moms right after birth and until they get more confident in getting their baby latched on correctly. It feels awkward for many moms at first, but once they see how it allows them to use both their hands more effectively, moms get more comfortable with it.

You will use the arm on the opposite side you will be feeding on to hold and support your baby, while you use the hand on the side you are feeding on to support your breast.

Lay your baby next to you, tummy-to-tummy, with your opposite hand supporting the back of his head. You want to make sure you are holding at the neck, so you are just guiding the head. You will use the other hand (on the same side the baby is feeding from) to hold and navigate your breast and nipple. Once the baby is securely latched on, you can move your arms to the cradle hold.

Cradle Hold:

This position is often used after your baby is a few weeks old and you are more confident in your breastfeeding hold. Your baby lays across your front at breast level with his/her tummy toward your chest.  Your baby’s head will be resting in the crook of your elbow, on the same side, you will be nursing from. You will use the opposite hand to help hold your breast if you need to help get your baby latched on properly.

Football Hold:

Your baby will lay along your side under your arm, with your hand supporting the back of the baby’s neck. The baby’s bottom should bump up against whatever you are sitting in (back of the chair, couch, etc.) Make sure to bend the baby’s legs at the hip, so that he does not push his feet against whatever you’re leaning against, as this will affect how he will be able to latch.

This hold is really great for a mom who had a cesarean birth and for women with large breasts.

Side-lying:

Lay your baby on his/her side with a pillow behind his back for support. You should also lay on your side facing your baby.  You might use a pillow behind your back or between your knees for support.  Your baby’s nose should be in line with your nipple.

There are other positions that can work for both you and your baby. Make sure that you and the baby are comfortable.  If not, try another position.

Signs that confirm a good latch:

• The tongue is seen when the bottom lip is pulled down
• Ears wiggle
• There is a circular movement of the jaw rather than rapid chin movement
• Cheeks are rounded
• You do not hear a clicking or smacking noises
• You can hear swallowing
• Chin is touching your breast
• When your baby comes off the breast, the nipple is not flattened or misshaped
• Any discomfort ends quickly after getting the baby latched on
• Your baby ends the feeding with signs of satiety/satisfaction. These signs include: the baby looks relaxed, “falls” off the breast, has open hands, and/or falls asleep.

Remember, breastfeeding should not be painful.  A good latch will help keep discomfort to a minimum.  When the baby has not latched on well, other problems can develop including cracked and sore nipples.  Once you get accustomed to positioning your baby and helping him/her get a good latch, breastfeeding can be a wonderful, pain-free bonding experience between you and your baby.

If you need further assistance, many hospitals have lactation consultants. Seek to work with a lactation consultant at the hospital or birthing center in which you deliver. If you are already home you can speak to your healthcare provider. You can also call the National Breastfeeding Helpline:  1-800-994-9662 or contact an independent lactation consultant.

Want to Know More?

• Breastfeeding Overview
• Increase Your Breast Milk Supply
• When to Introduce the Bottle

Compiled using information from the following sources:

1. La Leche League International. Breastfeeding Info & Breastfeeding With Sore Nipples.

2. Breastfeeding: How to Breastfeed Your Baby. Renfrew, Mary et al, 2004.

3. The Womanly Art of Breastfeeding. La Leche League International, Ch. 4. </p

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