What to Expect the First Year (19 page)

• Get ready for a good latch. Once you and your baby are in a comfortable position, gently tickle your baby's lips with your nipple until his or her mouth is open very wide—like a yawn. Some lactation specialists suggest aiming your nipple toward your baby's nose and then directing it down to the lower part of your baby's upper lip to get him or her to open the mouth very wide. This prevents the lower lip from getting tucked in during nursing. If your baby isn't opening up, you might try to squeeze some colostrum (and later on, milk) onto his or her lips to encourage latching on.

If your baby turns away, gently stroke the cheek on the side nearest you. The rooting reflex will make baby turn his or her head toward your breast. (Don't press on both cheeks to open your baby's mouth; that will just cause confusion.) Once baby starts catching on to latching on, just the feel of the breast, and sometimes even the smell of milk, will cause him or her to turn toward your nipple and open up wide.

Tickling baby's lip

• Seal the deal. Once the mouth is open wide, move your baby closer. Do not move your breast toward the baby, and don't push your baby's head into your breast. And be sure not to stuff your nipple into your baby's unwilling mouth—let your baby take the initiative. It might take a couple of attempts before your baby opens wide enough to latch on properly. Remember to keep your hold on your breast until baby has a firm grasp and is suckling well—don't let go of your breast too quickly.

Baby opens wide

• Check the latch. You'll know your baby is properly latched on when that sweet chin and the tip of that button nose are touching your breast. As your baby suckles, your nipple will be drawn to the rear of his or her throat, and those tiny gums will be compressing your areola. Baby's lips should be flanged outward, like fish lips, rather than tucked in. Also check to be sure your baby isn't sucking his or her own lower lip (newborns will suck on anything) or tongue (because your nipple is positioned underneath the tongue instead of over it). You can check by pulling baby's lower lip down during nursing. If it does seem to be the tongue that's being sucked, break the suction with your finger, remove your nipple, and make certain baby's tongue is lowered before you start again. If it's the lip, gently ease it out while baby suckles.

Breastfeeding won't hurt if your baby is latched on properly. If you feel nipple pain while nursing, your baby is probably chewing on your nipple instead of gumming the entire nipple and areola. Take baby off your breast (see below) and latch him or her on again. Your baby is also not latched on properly if you hear clicking noises.

Latching on

• Give baby some room to breathe. If your breast is blocking your baby's nose once he or she's latched on, lightly depress the breast with your finger. Elevating your baby slightly may also help provide a little breathing room. But as you maneuver, be sure not to loosen that latch you both worked so hard to achieve, or mess with alignment.

• Unlatch with care. If your baby has finished suckling but is still holding on to your breast, pulling it out abruptly can injure your nipple. Instead, break the suction first by putting your clean finger into the corner of baby's mouth
(to admit some air) and gently pushing your finger between his or her gums until you feel the release.

Breaking suction

Maybe you've heard that the best way to toughen up nipples is to go easy on them at first—starting out with short feeds (5 minutes per breast or so) to prevent soreness and cracking. But the truth is that sore nipples don't come from feeding too long, but from positioning wrong. So instead of setting time limits on feeds, let your sweetie take his or her sweet time at the breast—which initially can be a very long time. Don't be surprised if early feeds end up being marathon sessions—though the average time to complete a feeding is about 20 to 30 minutes, some newborns take up to 45 minutes. Don't pull the plug arbitrarily on the first breast—wait until your baby seems about ready to quit on breast one, and then offer (but don't force) breast two.

Ideally, at least one breast should be well drained at each feeding—and that's more important than being sure that baby feeds from both breasts. Then you'll know that your baby gets the hind (or fatty) milk that comes at the end of a feeding, and not just the foremilk (essentially, the skim milk) that comes at the start.

The best way to end a feeding is to wait until your baby lets go of the nipple. If your baby does not let go of the nipple (babies often drift off to sleep on the job), you'll know to end the feeding when the rhythmic suck-swallow pattern slows down to four sucks per one swallow. Often, your baby will fall asleep at the end of the first breast and either awaken to nurse from the second (after a good burp,
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) or sleep through until the next feeding. Start the next feeding on the breast that baby didn't nurse on at all last time or didn't drain thoroughly. As a reminder, you can fasten a safety pin to your nursing bra on the side you started with at the previous feeding, or you can tuck a nursing pad or tissue in the bra cup on that side. The pad also will absorb any leakage from the breast you're not nursing on (which will be letting down with anticipation).

At first, you'll need to nurse often—at least 8 to 12 times in 24 hours (sometimes even more if baby demands it), draining at least one breast at each feeding. Break that down, and it means you'll be nursing every 2 to 3 hours (counting from the beginning of each nursing session). But don't let the clock be your guide. Follow your baby's lead (unless your sleepyhead isn't waking up for feedings), keeping in mind that feeding patterns vary widely from baby to baby. Some newborns will need to nurse more often (every 1½ to 2 hours), others a little less frequently (every 3 hours). If you have a more frequent nipper, you may be going from one feeding to the next with only a little more than an hour in between—not much rest for your weary breasts. But don't worry. This frequency is only temporary, and as your milk supply increases and your baby gets bigger, the breaks between feedings will get longer.

How regularly spaced your baby's feedings are may vary, too, from those
of the baby down the block. Some thoughtful babies feed every 1½ hours during the day, but stretch the time between night feedings to 3 or even 4 hours. Consider yourself lucky if your baby falls into that category—just be sure to keep track of your baby's wet diapers to make sure he or she is getting enough milk with all that sleep (
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). Other babies might operate like clockwork around the clock—waking every 2½ hours for a feeding whether it's the middle of the morning or the middle of the night. Even these babies will settle down into a more civilized pattern over the next couple of months—as they begin to differentiate between day and night, their grateful parents will welcome the gradually longer stretches between nighttime feedings.

But while the temptation will be great to stretch out the time between feedings early on—especially when you're starting to feel like you're working all the shifts at a 24-hour diner—resist. Milk production is influenced by the frequency, intensity, and duration of suckling, especially in the first weeks of life. Cutting down on that necessarily frequent demand—or cutting nursing sessions short—will quickly sabotage your supply. So will letting baby sleep through feedings when he or she should be eating instead. If it's been 3 hours since your newborn last fed, then it's time for a wake-up call. (
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for techniques to wake your baby.)