Breastfeeding Baby After Birth

Tips and guidelines for nursing your baby after the delivery

It’s best for both you and your baby to start breastfeeding within the first hour after the birth. Depending on the type of delivery, most babies are alert and ready to feed. Your baby can be placed on your chest after delivery for skin-to-skin contact. In this position, some babies already seek out mom’s nipple.

Protocols and procedures in the delivery room do differ at facilities, so have a conversation with your healthcare provider prior to delivery to make your preferences known.  If you want to postpone your baby’s first bath, to hold and breastfeed baby in the first few hours after the birth, include this in your birth plan. Also tell your birth partner about your preferences, so he or she can advocate for you.

Breastfeeding immediately after a C-section is usually possible. If for any reason, you are not able to, you can request that your baby be brought to you in the recovery room. If you received general anaesthesia due to an emergency, you should be able to breastfeed as soon as you are awake and want to try.

Getting Started

Once your baby is put to the breast after the birth, he or she may latch on immediately and begin nursing, or your baby may need a little encouragement. You can express some colostrum (pre-milk) into baby’s mouth to stimulate their sense of smell and taste. If baby seems sleepy, gently stroke her arms and legs to waken them.

Some babies latch but don’t suck. If your baby doesn’t feed yet, don’t be concerned, just keep him or her close, preferably with skin-to-skin contact, and try again a little later. Some babies are very sleepy due to the pain medication given to mom during labour, including an epidural. A baby may also be very tired after a difficult natural vaginal delivery. Give baby time to rest a little first, then try again.

Benefits Of An Early Start

Breastfeeding stimulates the pituitary gland in your brain to release the hormone oxytocin, called the love or mothering hormone. Oxytocin is an important hormone for bonding and also promotes relaxation and lowers stress and anxiety.

When your baby nurses (or you express milk), it also stimulates the release of prolactin, the hormone that triggers milk production in your breasts. The first milk your breasts make is colostrum, a rich pre-milk that your baby needs in the first few days of life. Breastmilk is produced on a supply and demand basis. The more your baby feeds, the more milk you produce.

If you aren’t able to breastfeed your baby immediately after the birth for any reason, don’t be concerned that this means the end of your wish to breastfeed. Speak to the maternity ward staff about  starting to express your milk as soon as possible. Colostrum can be expressed and given to your baby and by expressing regularly, you stimulate your milk production. If you do express in the first few days, don’t be alarmed at how much milk you are producing. These tiny amounts are completely normal.

What You Need To Know

• Colostrum. This pre-milk is produced in very small amounts and packed with nutrients. The lower volume of milk in the first few days gives your baby a chance to practice sucking, breathing and swallowing at intervals, before a stronger flow of milk starts. Colostrum is rich in antibodies to boost your baby’s developing immune system.
• Transitional and mature milk. By day two to four, your milk will ‘come in’ – when your breasts begin producing the more mature milk your baby needs. At first colostrum mixes with the mature milk, called transitional milk. Your milk will only be fully mature at around two weeks after the birth. At each feed, your milk comes in two parts. When baby starts nursing, he or she takes in the ‘fore milk’, a watery milk to quench thirst. This is followed by the rich, nourishing ‘hind milk’. This milk is high in fat and kilojoules to satisfy your baby’s hunger. Let-down reflex is a warm sensation you feel in your breasts, as milk starts flowing into the milk ducts.
• Positioning. This is important for your comfort. In the first few days, the position you use may be dictated by your physical discomfort from an episiotomy (a cut made in the perineum, the muscular area between the vagina and anus, which requires sutures (stitches) or C-section. You can position your baby on your lap, parallel to your breasts, called a cradle position, or use the football position, where baby is tucked under one arm (like when you bath baby). It’s important to feel comfortable. Place a pillow behind your back, or under one arm to provide support. If you can’t find a comfortable sitting position, try lying on your side. You can put baby on a flat pillow to lift him or her a little higher, to reach your breast more easily.
• Latching. Your baby needs to take your whole areola (the dark part around your nipple) into his or her mouth. Trigger your baby’s ‘rooting reflex’. To do this, stroke your baby’s cheek, and he or she will turn their head to that side, seeking your nipple with an open mouth. When baby’s mouth is open, bring baby to the breast – don’t lean in to give the breast to baby.

If your baby struggles to latch, use the ‘C-hold’ technique:

• Cup your free hand around your breast in the shape of a ‘C’, with four fingers at the lower part of your breast and your thumb at the top
• Gently push up from the bottom and down from the top, like you’re holding a sandwich. This brings the nipple forward, helping baby to get a better latch

When baby is correctly latched, his or her bottom lip will be curled down against the lower part of your breast. You should feel a gentle pulling as baby starts sucking, but no pain. Watch baby’s jaw and ear area. Movement here indicates that he or she is sucking and swallowing milk. If it feels uncomfortable or sore, baby isn’t latched correctly. Detach your baby and try again.

If you do struggle to get baby to latch, consult a lactation specialist to assist and support you. They are available on the maternity ward while you are still in hospital, and some offer home visits.

• Burping your baby. Winding or burping you baby is an important part of the feed. This will help to remove air bubbles that that be swallowed. To burp your baby, you can place him/her with her chin resting on your shoulder (use a cloth to catch any spit up), lie him/her on your lap on their tummy, or sit baby on your lap. Gently tap baby’s back to release trapped air. One position may work better than another for your baby, so experiment a little. It’s okay to burp your baby after a feed, but if he/she seems uncomfortable during the feed, trying burping tem first. You can also burp her when you switch breasts.

• First feeds.  Your newborn will feed between eight and 12 times a day for the first few weeks. A newborn’s tummy is very small, about the size of a walnut, so they only need a very small amount of milk. On the first day, your baby needs about 5 to 7ml, increasing to around 60ml by day four.

Allow your baby to set the pace at the breast. It’s natural for babies to spend anything from a few minutes to longer than half an hour at the breast. He or she may even drink a little and take short naps between. Over the next few days, you can also look for cues that your baby may be hungry, like sucking his or her hands or rooting. Crying is a late sign of hunger, so look for other cues first.

Breastfeeding takes practice for both mom and baby. To get started, you may need some guidance from a midwife, or a lactation specialist. It can be a challenge at first, but once you master it, breastfeeding can be extremely rewarding for both you and your baby.

Contact your midwife or healthcare provider for support, advice and counselling.

Resources:  https://www.unicef.org/; https://kidshealth.org/; https://www.medela.com/https://www.betterhealth.vic.gov.au/; https://www.verywellfamily.com/;  https://www.healthychildren.org/; https://www.babycentre.co.uk/; https://www.llli.org/; https://www.webmd.com/