Good Breastfeeding Management
Introduction
Anything you do or don’t do in the first hours and days after giving birth can impact your breastfeeding. Because of this, it's important to strive to be as responsive as possible to your newborn. Oftentimes this will mean sleeping less than you normally do, and enlisting more help from others than you normally accept. The first few days and weeks after birth are an opportunity for you and to learn what your sweet baby's gestures and cries mean-and all of them mean something.
Duration and Frequency
Lets start from the very beginning...
Understanding Colostrum Volumes and Milk Supply
Colostrum is the first milk mom will make, and it starts being produced around 5 months of pregnancy in case baby is born early. Even at nine months, it is produced in small quantities because the stomach of a newborn is already born full (of amniotic fluid and meconium, the first stool of a baby, black and sticky consistency). In order for a baby to begin passing meconium (having their bowel movements), strong and efficient sucking at the breast is necessary. The small volume of colostrum and the high concentration of nutrients, antibodies and other important ingredients is what makes colostrum "liquid gold"--which even in small quantities plays an important role in your baby’s lifetime health.
Duration
In the old days it was believed that the frequency of stimulation was what helped to establish a good milk supply. In fact, it was recommended that a mother only nurse for only 5 to 10 minutes at a time, unlatching the baby frequently of allowing him to become full at the first breast. This caused babies to become frustrated and caused mom’s to get sore nipples because of the frequency with which they were unlatched. In addition, it limited the amounts of milk produced and consumed by the baby.
Today we know that is the frequency of nipple stimulation AND the volume of milk that is removed throughout the feeding or pump session that helps to establish a good milk supply. It’s important to know that if you only allow baby to latch on for a limited amount of time, your breasts will learn to make only a limited amount of milk. Granted, a baby who is constantly nursing on a nipple that hurts could mean that a baby isn't getting what they need, just like when a child takes a long time to drink from a straw they're chewing on rather than sucking from.
How long are feeds at the breast?
The average duration of a feeding at the breast varies. For example, you have to consider how long it has been since the last feed, or whether or not your baby is in a growth spurt. Although many believe in using the clock to measure the duration of the feeding, the best way to know is to look at notice whether or not the baby’s posture has changed completely during a feed. Usually hungry babies have very strong and firm posture, and babies who are full are much more relaxed. If we were to measure by time, as long as the baby changes position AND moms nipples didn't hurt, a feed can last between 10 minutes to half hour and sometimes longer. Plus, between full feeds some babies night snack for just a few minutes.
Frequency
The same way that a baby’s relaxed posture indicates their satiation (fullness), their tight or firm posture also indicates when it is time to nurse again. It is advisable to try to offer the breast at the first sign of hunger since babies are more willing to cooperate with feedings when they aren’t overly hungry. The average frequency between feedings may be around 1-2 hours at first, although some babies feed more frequently, and others less frequently. What is most important is that the breast be offered at the first sign of hunger, which can usually be seen by baby’s posture becoming firm or tight.
Note: If your baby is not showing hunger signs or cues, and still has not return to their birth weight (it is very normal for all babies to lose a few ounces after birth) is important to begin initiating feeds at least about 8 times a day and about two or three times at night. Once your baby has returned to birth weight (usually by 2 weeks), it is okay to begin feeding your baby on-demand. If your baby isn't back to birthweight after 2 weeks, call your baby's doctor and a lactation consultant.
Tips for breastfeeding initiation:
Avoid pacifiers as much as possible during the first three weeks of breastfeeding. Babies are born with instincts to suck in order to set right the volume of milk. Providing a pacifier to a baby can not only prove to be confusing, but it can also affect your milk supply. Babies who use pacifiers too much can often lose their suck vigor, and can become too tired to suck at the breast. If you're going to use a pacifier, make sure it's only after you're sure your baby has completed a feed.
Homework:
Duration and Frequency
Lets start from the very beginning...
Understanding Colostrum Volumes and Milk Supply
Colostrum is the first milk mom will make, and it starts being produced around 5 months of pregnancy in case baby is born early. Even at nine months, it is produced in small quantities because the stomach of a newborn is already born full (of amniotic fluid and meconium, the first stool of a baby, black and sticky consistency). In order for a baby to begin passing meconium (having their bowel movements), strong and efficient sucking at the breast is necessary. The small volume of colostrum and the high concentration of nutrients, antibodies and other important ingredients is what makes colostrum "liquid gold"--which even in small quantities plays an important role in your baby’s lifetime health.
Duration
In the old days it was believed that the frequency of stimulation was what helped to establish a good milk supply. In fact, it was recommended that a mother only nurse for only 5 to 10 minutes at a time, unlatching the baby frequently of allowing him to become full at the first breast. This caused babies to become frustrated and caused mom’s to get sore nipples because of the frequency with which they were unlatched. In addition, it limited the amounts of milk produced and consumed by the baby.
Today we know that is the frequency of nipple stimulation AND the volume of milk that is removed throughout the feeding or pump session that helps to establish a good milk supply. It’s important to know that if you only allow baby to latch on for a limited amount of time, your breasts will learn to make only a limited amount of milk. Granted, a baby who is constantly nursing on a nipple that hurts could mean that a baby isn't getting what they need, just like when a child takes a long time to drink from a straw they're chewing on rather than sucking from.
How long are feeds at the breast?
The average duration of a feeding at the breast varies. For example, you have to consider how long it has been since the last feed, or whether or not your baby is in a growth spurt. Although many believe in using the clock to measure the duration of the feeding, the best way to know is to look at notice whether or not the baby’s posture has changed completely during a feed. Usually hungry babies have very strong and firm posture, and babies who are full are much more relaxed. If we were to measure by time, as long as the baby changes position AND moms nipples didn't hurt, a feed can last between 10 minutes to half hour and sometimes longer. Plus, between full feeds some babies night snack for just a few minutes.
Frequency
The same way that a baby’s relaxed posture indicates their satiation (fullness), their tight or firm posture also indicates when it is time to nurse again. It is advisable to try to offer the breast at the first sign of hunger since babies are more willing to cooperate with feedings when they aren’t overly hungry. The average frequency between feedings may be around 1-2 hours at first, although some babies feed more frequently, and others less frequently. What is most important is that the breast be offered at the first sign of hunger, which can usually be seen by baby’s posture becoming firm or tight.
Note: If your baby is not showing hunger signs or cues, and still has not return to their birth weight (it is very normal for all babies to lose a few ounces after birth) is important to begin initiating feeds at least about 8 times a day and about two or three times at night. Once your baby has returned to birth weight (usually by 2 weeks), it is okay to begin feeding your baby on-demand. If your baby isn't back to birthweight after 2 weeks, call your baby's doctor and a lactation consultant.
Tips for breastfeeding initiation:
Avoid pacifiers as much as possible during the first three weeks of breastfeeding. Babies are born with instincts to suck in order to set right the volume of milk. Providing a pacifier to a baby can not only prove to be confusing, but it can also affect your milk supply. Babies who use pacifiers too much can often lose their suck vigor, and can become too tired to suck at the breast. If you're going to use a pacifier, make sure it's only after you're sure your baby has completed a feed.
Homework:
- Continue learning about the importance of colostrum
- Read more about skin-to-skin care
- Identify your breastfeeding resources in your birth setting (hospital, birth center, private practice IBCLCs who can come to your home)
- Share this page with your partner, or with people who support your breastfeeding
Use of this class by non-parents: This class has been written for parents, and while birth and breastfeeding professionals may share it with their clients, it must be shared as a web-links or printed directly from this site. This class or any portion of it cannot be used a class outline for another breastfeeding professionals' breastfeeding class, nor can any portion of it be copied or pasted. Any dissemination of this class must be in its entire original form (weblink or printed pages) and must cite Breastfeeding Housecalls and Laura Gruber, IBCLC as its author and owner.
