8. Length of Feedings. Most newborns want to nurse 10-15minutes at each breast. It may take 2-3 minutes for the milk to let down in any quantity, especially in the first few days of nursing. The length of a breast-feeding session should be determined by the baby’s interest and response. Infants will usually suck eagerly for the first 10 minutes or so and then the flow of milk may decrease and your baby may begin to doze or lose interest. That’s the time to switch baby over to the other breast. You may want to stop at this point to burp your baby (some babies may not burp with every feeding) or change the diaper and then get your baby started on the other side. . As long as your baby is sucking correctly, you can let your baby nurse as long as baby wants to on the second side.

9. Ending a Feeding. If you need to take the baby off the breast and the baby is still latched on, slip your little finger into the corner of your baby’s mouth to break the suction. Then, take your baby off your breast.

10. Breast Milk. Your colostrum (the clearish/yellowish fluid produced by your breasts the first few days of breast-feeding) is super rich with nutrients and substances that protect your baby’s health. Even just a little colostrum goes a long way. About three days after your baby is born you will notice that your breast milk is changing from colostrum to a white, thinner (maybe bluish) appearance. This is the "mature milk."

You may be uncomfortable and your breast may become full and hard when the mature milk comes in. You may find that your baby is not able to latch onto your nipple and areola properly because your breasts are so full of milk and feel hard. (Remember if your baby doesn’t latch on properly you will get sore nipples.)

If your breasts become engorged, use moist heat (warm compresses or a warm shower) on your breasts and gently massage them before nursing. Hand express or pump milk until the areola softens, then encourage the baby to nurse. Breast-feed at least every 2 to 3 hours during this period, and after nursing apply cold packs briefly to the breast to relieve swelling.

Another effective treatment for uncomfortable, engorged breasts is placing cabbage leaves on your breasts.       

1. Separate individual cabbage leaves from a head of cabbage and rinse in cold water.
2. Pat the leaves with paper towels to remove excess moisture.
3. Tap the leaves with a wooden spoon to soften the cabbage leaves a bit.
4. Lie on your back; cover your breasts with the cabbage leaves without covering your nipples.
5. Relax for about 20 minutes; the cabbage leaves will soften and become warm.
6. Remove the leaves.
7. You can use the cabbage leaves treatment up to four times in a 24-hour period.

If you get sore or uncomfortable during the engorgement period, call the nurse practitioner.

11. How to tell if your baby is getting enough milk. Most breast-fed babies nurse eight to twelve times in 24-hours during the first two weeks of life. After the mature milk appears, the baby should wet about six diapers in 24-hours, have at least two stools a day, and appear satisfied after each feeding. A breast-fed baby doesn’t always eat on schedule; on some days, your baby will seem to want to nurse all the time. The days of frequent feedings correspond to your baby’s growth spurts, and allowing your baby to breast-feed as baby wants during these days will increase your milk supply to meet your baby’s increased demand.

Your infant’s stools may be loose, yellow, seedy, and frequent. Green and brown colored bowel movements are also normal. 

Babies will differ in their eating behaviors, bowel movements and number of wet diapers. If you are worried that your baby isn’t getting enough milk, call us and we will be glad to weigh your baby at the office to determine if your baby is growing properly.

12. Supplements. Do not give formula, water, or solids until the pediatrician or nurse practitioner recommend that you do. Babies do not need nourishment other than their mother’s milk for the first several months of life.

Sucking on a bottle or pacifier may confuse a baby when learning to nurse. If you need to give your baby a bottle, try to wait until your baby is four weeks old unless the pediatrician or nurse practitioner feel your baby needs supplementation due to health problems.

13. Nipple soreness or pain. If your baby is latching on and sucking correctly you should not feel any painful pressure on your nipple. If baby seems to be sucking incorrectly or you feel pain as your baby nurses, you may have to make your baby stop and start over again. Break the suction by putting your finger in the side of baby’s mouth and either pressing on your breast or gently pulling on baby’s cheek. Don’t let y our baby continue to suck incorrectly because it leads to nipple soreness and poor sucking patterns can be hard to correct later on.

If soreness or nipple pain continues check for these possible causes:

-Do not let baby slide onto the nipple stopping short of the correct sucking position. Be sure baby opens wide to take the nipple far back into the baby’s mouth.

-If baby persistently clamps down too hard as baby starts to suck, depress the baby’s lower jaw with your finger by pulling down on the chin as you tell baby to "open" in a clear, commanding tone of voice.

-If nipple pain continues, pull baby’s lower lip down while baby is nursing and check to see if baby’s tongue is visible between baby’s lower lip and the breast. If you cannot see the tongue, baby may be sucking it along with your nipple. Take baby off the breast and restart nursing, being sure baby’s mouth is open very wide and baby’s tongue is below the nipple when baby latches on.

You may want to try some of the following suggestions to help you take care of your sore nipples:

• Nurse your baby more frequently, but for shorter periods of time. Your breasts are less likely to overfill and your baby is more likely to suckle gently.
• Offer the less sore breast first most of the time. This will give your milk a chance to let down on the sore side, and the baby won’t be sucking as hard by the time baby gets around to baby’s second course.
• To ease pain, briefly apply either crushed ice wrapped in a wet washcloth or gauze squares that have been dampened and put in the freezer, to your nipples just before a feeding.
• Avoid irritating substances. Do not use soap, alcohol, tincture of benzoin, or witch hazel on your nipples.
• Do not wipe away milk left on your breast after a nursing. Let it dry there; it has healing properties.
• Soothe the soreness with U.S.P. Modified Lanolin ("Lansinoh" or "Pure Lan"). We do not recommend using vitamin E or other creams on your nipples.
• Keep your nipples dry. If you wear breast pads to catch leaking milk, change them when they get wet. Do not use breast pads with plastic liners. If you wear breast cups to bring out inverted nipples or for sore nipples, empty them often. Occasionally undo your bra flaps under your clothing and uncover your nipples as much as possible.
• Check with your baby’s doctor or nurse practitioner about other medications and treatments you can use to relieve the soreness.

14. Taking Care of Yourself. It is important that you take care of yourself while you’re nursing your baby.

• Eat a well balanced diet; you will need 500 extra calories while you are nursing.
• Drinks lots of water. If you feel thirsty, you are not drinking enough water.
• Continue with your prenatal vitamins while nursing.
• Use your energy to take care of your baby and yourself. You will need extra rest the first few weeks after your baby is born.
• If you smoke, try to cut down as nicotine will pass into your breast milk. Don’t smoke just before nursing as smoking hampers the release of milk from your breasts.
• Many drugs, both prescription and nonprescription, pass through breast milk to the baby. Always consult your baby’s doctor or nurse practitioner before taking any medications while nursing, including nonprescription drugs.
• Wear a well-fitting nursing bra for convenience and support. Avoid underwire bras.
• If either breast develops a red, hot, tender area, if you have a fever and/or you develop flu-like symptoms of body aches, notify your doctor or nurse practitioner.
• If you have questions about breast-feeding or any difficulties breast-feeding your baby, help is available. Just call and we will be glad to help you with any concerns you have.

Bottle Feeding - Go to Page 3