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Breastfeeding in the Hospital
Getting a great start to breastfeeding can avoid a lot of the common problems and concerns that many women face. The first 48 hours of nursing can be critical in sending signals to the brain to produce a good supply of milk. Whether in a hospital or out-of-hospital setting, once the baby is delivered, establishing breastfeeding should become a primary focus of a new mother and those supporting her.
Here's some tips all expectant and new mothers should know:
Breastfeeding immediately after birth signals the body that it's time to make breast milk. Yes, the body knows when the baby has been delivered. But putting the baby to breast is the way the body knows that baby has been delivered healthy.
Healthy, full-term newborn babies are usually alert right after delivery, and are born with an instinctive need to suck. The Montgomery glands on the breast secrete a lubricating fluid that smells similar to the amniotic fluid as a sort of "target" for the baby. The mother's body is a perfect warmer for a newborn and the mother's familiar heartbeat and skin-to-skin contact is known to be stabilizing to the baby.
After about an hour, babies tend to get sleepy and less responsive, so bringing the baby to breast immediately after birth to suckle freely is important for the baby and for the mother. This is also supported the American Academy of Pediatrics as recommended standard practice. If your hospital has a different procedure, discuss with them the AAP recommendation (link included below) and do your best to bring the baby to breast as soon as possible.
Babies are born with a very strong instinctual need to suck for about the first three days. Mothers' bodies require a great amount of stimulation at the breast (in the form of a nursing baby, or when that is not possible a breast pump) in those same first three days in order to signal the body to begin to produce sufficient breast milk to follow up the initial colostrum (special concentrated milk perfect for newborns). Isn't nature wonderful?
Babies don't receive high volumes of milk in the form of colostrum until the transition to the thinner and more plentiful mature milk. But early nursing is more about satisfying the baby's and the mother's sucking needs while delivering the concentrated nutrition and important immunities in that colostrum.
Newborn babies should be at the breast as often as willing and possible. Babies should nurse a minimum of 8-12 times in 24 hours, through both day and night, although more is great as well. Watch the baby for licking and looking, a sort of "lizard face" made by a newborn even when they appear to be sleeping that is the earliest sign of interest and willingness to nurse.
While it is not necessary to fixate on timing feedings or alternating breasts in a scheduled way, be sure to provide roughly equal stimulation to both breasts. As a bonus, the more often that babies nurse in the first days, the lower their chances of developing jaundice.
Use Support Early
Don't stress too much about the mechanics of breastfeeding for the very first feeding at delivery. Just get the baby to the breast and enjoy your wonderful little miracle. But I *highly recommend* getting a knowledgeable breastfeeding professional to assist in the second feeding, or at least as soon as possible. A lactation consultant, lactation educator or educated RN can assess the baby's latch as well as quickly identify any common physical concerns.
The sooner a good latch is established the less likely a new mother is to develop sore nipples. Let me underscore the importance of that point. The sore nipples that you may have heard so much about are avoidable. Remember that making milk is a natural act of the body, but breastfeeding is a learned skill. There are tips and tricks for positioning and aligning the baby, as well as how to "teach" the baby to latch properly to the breast. In the past, mothers passed this knowledge onto one another, but in an increasingly medicalized world, this role is more likely to be filled by a lactation professional in a hospital setting.
Finding out the whereabouts and availability of lactation support as soon as possible after delivery, to have someone help as soon as possible is a great way to avoid sore nipples or other problems in later days. If no one will be available on a 24/7 basis, it might be a good idea to identify an independent professional, local La Leche League leader or even an experienced and knowledgeable breastfeeding friend who can be called upon for support if needed.
AAP Policy on Breastfeeding - Section on Breastfeeding for Healthy Term Infants (see especially secs. 2-7)
Looking for great breastfeeding support books to read before the baby is born and bring to the hospital? These are two of my favorites:
Disclaimer: All material on the BellaOnline.com Breastfeeding website is provided for educational purposes only and does not constitute medical advice. Although every effort is made to provide accurate and up-to-date information as of the date of publication, the author is neither a medical doctor, health practitioner, nor an International Board Certified Lactation Consultant (IBCLC). If you are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation. Information obtained from the Internet can never take the place of a personal consultation with a licensed health care provider, and neither the author nor BellaOnline.com assume any legal responsibility to update the information contained on this site or for any inaccurate or incorrect information contained on this site, and do not accept any responsibility for any decisions you may make as a result of the information contained on this site or in any referenced or linked materials written by others.
Content copyright © 2013 by Nicki Heskin. All rights reserved.
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