#1 (Most important rule) FEED THE BABY
Ideally, you will do this by directly breastfeeding. If not, it may with formula or pumped milk.
A well-fed baby is a better breastfeeder. So it is in your best interest to make sure your baby is getting enough to eat at any stage of breastfeeding. So, for a newborn baby, that means if your baby has lost 10% or more of her birth weight, supplementing with expressed milk or a little formula to help her regain her birth weight will support breastfeeding success overall. Just remember, follow all three rules for optimal breastfeeding success.
- Maintain skin-to-skin contact immediately after birth (or ASAP) for about one to two hours or until baby has breastfed.
- Breastfeed whenever baby shows hunger cues (tongue darting, hand sucking, rooting).
- Encourage an active sucking pattern of six to eight sucks in a row; pause; repeat by keeping baby skin-to-skin and in just a diaper, tickling his feet, blowing in his face, etc.
- Here is a video of what a newborn’s “nibbling pattern” looks like. Expect to see that pattern for the first three days before your milk comes in.
- Hand express after every breastfeeding session into a teaspoon and top baby off with this milk. This will help ensure that the breast is well drained, your milk comes in sooner, and baby doesn’t lose too much weight. Check out an instructional video here.
- Limit how many different people are holding the baby in the first three to five days of baby’s life. At least every two hours (but ideally more frequently) bring baby back skin-to-skin and look for feeding cues.
- Rest whenever you can and don’t let visitors interrupt your rest time.
- Keep track of your feedings, poops, and pees on the breastfeeding diaper log. This is the main way that you will know if baby is getting “enough.”
- Aim for a comfortable latch. It may or may not look “textbook,” but it needs to feel like a strong tug, not a pinch. You should describe your nipples as tender or sore, not excruciating or destroyed. If your nipples are cracked, bleeding, or too painful to breastfeed on, don’t accept this as normal. Seek further help.
- If baby is to be fed anything other than breastmilk, there should be a medical reason for it. This should be determined by your pediatrician, not a nurse. The amount of formula given to the baby should be appropriate for the baby’s age.
- You may opt to give your baby formula in place of breastfeeding, but you must understand that this is risky to breastfeeding and can be a slippery slope leading to ultimate breastfeed failure if not done properly. If you decide to do it, follow Rule #2 closely.
Anytime a baby is fed a bottle, you must follow Rule #2…
#2 Protect Your Milk Supply
- If baby isn’t eating directly at the breast, you have to let your body know!
- For the first three days, before your milk comes in, hand expression is the most effective way to collect colostrum. This should be done in conjunction with breastfeeding or pumping. When breastfeeding, hand express after breastfeeding session into a teaspoon and give this to the baby.
- If you are unable to directly breastfeed for any reason, you must stimulate your breasts as often as the baby should be eating with a high quality double electric breastpump. In the first three days, hand express first into a small cup or bottle, then pump both breasts for about 15 minutes.
- Pumping shouldn’t hurt. The vacuum should be set on the highest comfortable setting. More suction doesn’t mean more milk, it just means more pain.
- Your nipple should move freely in and out of the flange. If they are rubbing, you may need a larger flange size.
- Go no longer than four to five hours without pumping. Your body doesn’t like to be full this long and your milk supply may decrease as a result of it.
- Be proud of every drop you get and don’t compare it too closely with what the baby is eating. You love your baby, you don’t love your pump, and love is a really important element of expressing milk, so don’t assume that what the pump gets out is what the baby is getting out, too.
Pumping in place of breastfeeding can be really exhausting, discouraging, and overwhelming. So can breastfeeding on demand. Every breastfeeding mother deserves support throughout this process, so don’t skip over Rule #3…
#3 Seek (the right) Help
And know where to find this help before baby is born!
- You need to have an International Board Certified Lactation Consultant (IBCLC) that you know, like, and trust as a contact on your cell phone before your baby is born.
- Not all IBCLCs are created equally (much like every other healthcare professional), so do your homework and make sure to find the right one for you. If you don’t like the help you’ve gotten, get new help.
- Know which Breastfeeding Support Group you will attend after the baby is born.
- Acknowledge that although your pediatrician, the nurses in the pediatrician’s office, your OB/GYN, the nurses in your OB/GYN office, your mother, your sister, your friends, and the internet all have advice to give about breastfeeding, none of them is a breastfeeding expert. Only an IBCLC is a breastfeeding expert.
- Be very careful on the internet.
- If you have fed your baby and protected your milk supply, a good IBCLC can fix almost anything days, weeks, or months after the baby is born.
Breastfeeding is a marathon, not a sprint. It isn’t about everything going perfectly in the early weeks; it is about surviving the early weeks by following the rules and doing what it takes to make breastfeeding work long term.