Preparing to Breastfeed

Keep the skin around your nipples healthy. Avoid excess rubbing or stimulation since this might damage the skin. Your body will prepare your breasts for breastfeeding. Rubbing or stimulating your nipples can cause your uterus to contract, leading to a possibility of preterm labor if you are early in your pregnancy, or undue stress on the baby if you are near delivering. It’s best to avoid using lotions or alcohol on your breasts. You can do normal cleaning of the breasts when bathing or showering. If you have inverted nipples (nipples that are turned inward) ask about what you may need to do to when breastfeeding. Try to attend a breastfeeding class and read some pamphlets or books on breastfeeding. Ask your doctor or nurse for more information.

You will need to take in about 500 extra calories each day to help you produce good breast milk. Otherwise, your diet should be like the diet recommended during pregnancy. To be sure you are not getting too many calories, watch your weight. You should not gain weight at this time.

These can get into your breast milk. Don’t use anything, even nonprescription medicine from the drug store, unless you first check with your doctor. It’s best to avoid alcohol and smoking while you are pregnant and even later when breastfeeding.

The first time to breastfeed should be as soon as possible after the delivery since the baby is more awake and willing to nurse at this time. Nursing about every one and a half to three hours helps bring in milk, gives the baby fluid that it needs, and helps the baby’s digestive system start cleaning itself out. Nursing can usually begin when the baby is first brought to you. The baby’s body should be turned toward you with the baby’s tummy turned to your tummy and the baby’s knees against your stomach. This position prevents the baby’s mouth from slipping and helps keep your nipples from getting sore. Touching the baby’s lower lip will usually make its mouth open wide so you can then bring the baby to your breast to latch. As much of the areola (the dark circle around your nipple) as possible should be in the baby’s mouth. After about ten to fifteen minutes, gently put your little finger in the corner of the baby’s mouth and push the mouth open. This breaks the suction and lets you easily remove the nipple. Switch to the other breast and let the baby nurse for another ten to fifteen minutes. By the time you get home, the feeding time should approach about ten minutes on each breast. Babies don’t follow set schedules and may not nurse the same amount of time at each feeding. Most babies need and want about 10-12 feedings every 24 hours. It is okay to nurse about every one and a half hours. The feedings don’t have to be timed exactly.

The first few feedings are usually a “get acquainted” time. Your baby may not be very hungry at first, and your milk will yet have started flowing fully. Try to nurse anyway, but don’t get discouraged if the baby does not seem to get much. The baby will be getting colostrum (the very early milk that the breast makes) which is very healthy.

Learn everything you need to know about breastfeeding positioning and more in 'Your Guide to Breastfeeding' from The U.S. Department of Health & Human Services Office on Women's Health.

• Watch that the baby is swallowing while nursing
• Feeds at least six times in 24 hours during the first month of life
• The baby should be content for one or more hours after feeding, not crying when starting to feed or during the time right after finished feeding
• The baby has six to eight wet cloth diapers a day, or five to six wet disposable diapers a day (the baby may have less the first few days after birth)
• The baby is having stools (bowel movements) at least every day or two

If you have any problems at all, don’t get discouraged and think it would be easier to switch to a bottle. First, talk to your doctor or the nursing staff and let them help you. You can also call the hospital nursery (anytime day and night). There are support groups and breast-feeding centers in many states. Ask the doctor, the hospital nursery or check your phone book. One suggestion would be the La Leche League.

If breast-feeding is delayed after birth, stopped for a while, or if you and baby are separated, you will want to use a breast pump or hand expression to keep up your milk supply and empty your breasts. Ideally, if the baby is not nursing 6 hours after birth, you should begin to stimulate your milk supply by stimulating your breasts. Ask the hospital personnel for assistance with this.

To use a breast pump, follow these steps. There are many types of breast pumps you can buy. Your hospital can recommend a breast pump to use (some may even sell or rent them). Whichever type you choose, always:

• Read the instructions carefully.
• Wash your hands and cleanse your breast with clean water and dry.
• Get comfortable and relax. Think about the baby.
• Massage your breast from the chest wall to the nipple with the flat of the hand. Use your fingertips to massage in circles from the full area toward the nipple
• Begin pumping (it should NOT hurt).
• Alternate breasts as the flow decreases, or every 5-10 minutes if pumping to stimulate supply.
• Save the milk in a sterilized baby bottle or throw away bottle liner, cover it and place it in the refrigerator. It can stay for a few days and be given to your baby by a bottle. It can also be frozen for longer periods.

To hand express, follow these steps:

• Wash your hands and cleanse your breasts with clean water and dry.
• Get comfortable and relax. Think about the baby.
• Massage your breast from the chest wall to the nipple with the flat of the hand.
• Use fingertips to massage in circles from the full area toward the nipple.
• Place thumb and fingers one and a half inches from the nipple.
• Push back towards the chest wall.
• Roll your fingers forward compressing the milk ducts.
• Work your fingers around the breast to empty all ducts.
• Switch from the right to the left breast to increase the amount expressed.
• Save the milk in a sterilized baby bottle or throw away bottle liner, cover it and place it in the refrigerator. It can stay for a few days and be given to your baby by a bottle. It can also be frozen for longer periods.

Avoid sliding your fingers over skin or pulling on the nipple itself. Fingers should remain away from nipple so milk doesn’t run over the fingers. Milk that runs over your fingers might get germs in it and should be thrown away. Whatever method you choose, pump or hand, it will take time and practice to master this. Consider your first few attempts as practice and don’t expect any milk on your first few tries. If you do get milk the first few times, consider it a bonus.