How to Breastfeed

If you are here, you may be having difficulty with breastfeeding or maybe you are learning before you deliver. Either way, you came to the right place.

Below are some excerpts from my book, to teach you how to breastfeed.

Here are some basic guidelines for a successful breastfeeding journey:

Breastmilk supply is based on supply and demand, the more you empty the more you make.
Feed whenever baby shows feeding cues (awake, rooting, smacking, alert, hands-to-mouth, etc.)
Feed at least 8+ times in 24 hours (~every 2-3 hours and on-demand, max 5 hours at night between feeds) to maintain milk supply.
Attempt to feed on both breasts for each feeding, burp between breasts (first side is "entrée" second side is "dessert").
Alternate the breast you start on foreach feeding.
Wake baby before feedings (skin-to-skin) and keep baby awake/active sucking throughout feeding
Wear baby skin-to-skin or in infant carrier (AKA Kangaroo care) as much as possible
Position infant tummy to tummy, nose to nipple, and bring baby to breast to obtain a deep asymmetrical latch to prevent nipple damage.
Hand express at least 5 minutes, 5x per day in the first 5 days after delivery to increase supply.
In the first 24 hours of life, hand express if infant is not latching
Wear infant skin-to-skin and in kangaroo care as much as possible.
Breast milk storage guidelines: how long is milk good FOUR? (4 hours max at room temp, 4 days max in fridge, 4 months+ freezer)
Use a breast pump if separated from your baby or infant is not latching effectively.
Use the proper flange size for your nipples when pumping.
Monitor for normal infant output (number of minimum poops and pees correlates with days old until ~day 5)
Baby should be back to birth weight by 2 weeks of life
Baby should have yellow/seedy stools by day 5 of life.
Cluster feeding, second night syndrome and “the witching hour” are all normal and expected, your baby is not "starving"
Do not go beyond 5 hours at night without attempting to feed infant.
Supplement only if there is a medical necessity.
May offer a bottle/pacifier once breastfeeding is established (~4-6 weeks)
Try infant-led breastfeeding positions
General intake for infants is 24 oz of breast milk in 24 hours (~1 oz per hour, divided into # of feedings per day) after the first 2 weeks once milk supply is mature
Weight loss is normal in the first few days after birth, should be <10% weight loss for full-term healthy infant
Normal infant growth is based on their specific growth curve, they should gain approximately 1 oz per day after initial loss after birth

Latching

When you are breastfeeding, the latch is everything. A latch is when your baby attaches their mouth around your nipple and areola during a feeding session. It should be deep and asymmetrical around the nipple and areola. If the baby’s mouth is not wide enough or the nipple is not far enough into your baby’s mouth, we call that a shallow latch. In order to properly empty the breast, your baby needs to have a deep latch with as much of the nipple and areola into their mouth as possible. See the video above.

Three "Rules" for Latching

In any breastfeeding position, there are only 3 main rules to obtaining a deep, asymmetrical latch. These three rules are:

1. Tummy-to-tummy

Have your baby’s spine aligned so their tummy is facing you and so is their face/mouth. You do not want your baby’s tummy facing to the ceiling and head turned towards you, which is hard to swallow. The spine should be straight and head tilted slightly back. Tilt your head so your chin is toughing your chest and try to swallow - it's hard, right?

2. Nose-to-nipple

By aiming your baby’s nose at your nipple, the lower lip should be placed on the BOTTOM of the areola, creating an asymmetrical latch. Think about how you take a bit of a hamburger or a big bite of sandwich – the lower lip hits first and then the mouth comes over the bite like an arch. The nipple can aim at the nose or right between the upper lip and nose. Your nipple should be pointing up in the baby's roof of the mouth when your baby latches on. The nipple should not be aimed at your baby's mouth when latching.

3. Baby-to-breast

Support your baby behind the shoulder blades with your thumb and fingers just below their ears.

Bring your baby towards you, rather than chasing your baby with your breast. The chin should touch the breast first when latching, with the bottom lip touching near/on the bottom rim of your areola. Then, the mouth scoops and latches over the nipple.

Your baby should be brought to the natural position your breast sits, even if they are low.

The First Latch

During the first hour of life, babies are usually more alert and will begin searching for your breasts. If allowed, babies will often self-attach to the breast in time. Mother responds to baby and gently assists baby to the nipple as a guide rather than a force, allowing the baby to lead the latch. This process, known as “the breast crawl,” is infant-led feeding where babies can use their innate behaviors and instincts to literally crawl to the breast! If the baby is separated during this time, they are robbed of this biological process, which is another main reason why the golden hours should be uninterrupted from routine interventions.

Feeding your infant within the first hour of life is very important not only for them, but also for establishing your milk supply. By removing milk within the first hour after you deliver, it sends signals to your body to make more milk when those signals are the strongest. Watch the video below from firstdroplets.com to learn more from Jane Morton about these "First Droplets." It is one of the most thorough videos about latching, hand expression, and establishing your milk supply early on.

If you are unable to latch your baby within this first hour for any reason, it is important to take your milk supply into your own hands and hand express to empty the milk. By emptying this first milk, you send the strongest signals to your body to start establishing your milk supply.

How to know your baby is "getting enough?"

1. Weight gain

Weight loss is normal in the first few days after birth, but it should be <10% weight loss from their birth weight for a full-term healthy infant. If weight loss is >10%, see a lactation consultant BEFORE starting supplementation. After day 3-5 ish of life, your mature milk will transition and the volume will increase, baby should start gaining weight. Baby should be back to birth weight by 2 weeks of life. Normal infant growth is based on their specific growth curve. They should gain approximately 1 oz per day after initial loss after birth.

2. Poops and pees

Monitor for normal infant output, it generally correlates with days old until ~day 5. For example, on day 1, infants should have a minimum of 1 poop and 1 pee. On day 2, a minimum of two poops and 2 pees...up until day 5 of life. Infant should have yellow, seedy stools by day 5 of life. After day 5, expect approximately 5 poops and pees per day until infant is about 2 months old, then expect one ppop per day.

3. Hearing swallowing during feed, baby satisfied after feed (after day 5 of life)

Once your mature milk transitions, you will hear intermittent swallows throughout the feed. Infant should stay awake at the breast during the feed and should appear sleepy and satisfied after the feed, AKA "milk drunk."

The Newborn Care & Breastfeeding Bible Book

For more in-depth knowledge, my book is available for purchase on Amazon.

This 118 page easy-to-read book includes all the basics you need to know about newborns including evidence based information, links to articles, and links to correlating educational videos.

Preview on Amazon

If you are a visual learner, please watch my FREE educational videos on TikTok

@ThePostpartumNurse

Medical Disclaimer: The information provided is intended solely for general educational and informational purposes only. It is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your healthcare provider for any questions you may have regarding your or your infant’s medical condition. Never disregard professional medical advice or delay in seeking it because of something you have received in this book. The author has provided general information and cannot make any assurances in regard to the applicability of any information to any particular person in any particular set of circumstances. The reader assumes all risk of taking any action or making any decision based on the information provided. The author shall have no liability or responsibility for any such action taken or decision made by any reader of this information, and no liability for any loss, injury, damage, or impairment allegedly arising from the information provided.