Successful breastfeeding establishment

In the first weeks of breastfeeding, milk is produced in the mother’s breast through a demand and supply mechanism, so that the mother develops the breast infrastructure for milk production and produces milk in accordance with the latch and milk transfer stimulus. But this does not happen over-night, it is a process. Getting breastfeeding established takes a ‘time investment’ and the first days-weeks can be challenging.

Seek help often with first breastfeeding attempts. In the delivery room or operating room, ask the midwife for help with skin-to-skin contact, identifying the baby’s readiness to breastfeed and attaching the baby to the breast. The first latch-ons teach the baby and you the breastfeeding technique and signals to your body that your baby is alive and needs you, and are important for the success of breastfeeding later on.

Seek the help of lactation consultant and / or nurses with appropriate training. It is perfectly fine to ask several times for help in attaching the baby to the breast in those first days, this is a technique that sometimes takes time to acquire. You will not always be offered, but it is important to know how to ask proactively. Know that every hospital should have a qualified lactation consultant. Look for her. However, most of the staff have experience in helping mothers with latch techniques, so don’t just wait for someone to offer.

It is a good thing if your baby wants to eat “all the time”. The more your baby is breastfed in the first few days (i.e .: more than 8 times in 24 hours) the greater the chances that she will not lose excessive percentages of weight, and also reduce the chance of developing neonatal jaundice. Do not hesitate to breastfeed your baby whenever she seems interested even if she just finished breastfeeding. Offer the breast often. Breastfeeding sessions can be very long, even an hour long, but can also be very short – a few minutes, and it varies between different mothers, babies, and sessions. It normally takes several weeks for the sessions to shorten and get in some order.

Breast stimulation is helpful in establishing breastfeeding and good milk production. If baby is sleepy, you should add manual milk expressions between breastfeeding attempts.

Skin to skin

Place the baby on the breast and / or place the baby skin-to-skin on your chest, belly to belly, wearing only a diaper as often as you can (if it is cool, cover both of your bodies with a blanket).

The baby’s contact with your body and the stimulus of the breast contributes to the success of breastfeeding by increasing the secretion of hormones necessary for the production of milk and the maturation of breast tissue. In addition, when a baby is in skin-to-skin contact with you, the baby will suckle more often and it will be easier for you to identify her signs of hunger and when she is ready for the next breastfeeding already before she cries.

Skin-to-skin contact can be made, even when she is connected to monitors.
If you had a caesarean section, ask for help in a position that will not be painful. You can place a pillow or blanket on the incision area to avoid painful touch.

Rooming In.

Staying in the same room with your baby, as close as possible to the birth, increases the chance of a successful breastfeeding initiation and progress. When you have your baby by your side, you can have a truly responsive feeding and not obey to any specific clock. You will be able to respond to the early signs of hunger and your baby will not have to cry. Breastfeeding a calm baby is easier and more pleasant for both mother and baby. Even if the fancy ‘rooming-in’ room in the ward is not available, you have the right to demand that your baby be with you without separation in any room.

If mother and baby cannot room together for any reason

If your baby is hospitalized in the NICU, try to stay with her as much as possible, at the same time notify the professional staff that you are interested in breastfeeding and ask to speak with the head of the unit to understand how breastfeeding can be integrated into medical care. There are usually also breastfeeding or pumping rooms / sections next to the NICU. If baby is not directly breastfeeding, ask to provide hand expressed or pumped breast milk and ask for guidance on how to provide milk to the NICU. Know how much milk is expected per feeding at any day after birth.

If for medical reasons your baby can not suckle directly from the breast in the first day or in the first days, milk production should be stimulated frequently, by manual expression and / or pumping at the same frequency a healthy term baby would feed, which is at least every 2-3 hours, including during the night. It may be difficult, but its the only way to signal to your body that this milk is needed. Initially expect only several drops every attempt, and it will take time to express each meal. Volumes will gradually increase as you get familiar with the process and as you keep expressing frequently and effectively. Be patient, and proactive. It pays off.

Link to educational video by Dr. Jane Morton From Stanford Medicine – BREASTFEEDING IN THE FIRST HOUR VIDEO