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The First Weeks of Breastfeeding

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The First Weeks of BreastfeedingIf my own experience is typical of others, you no doubt felt frightened and insecure upon first arriving home after delivery. I brought my fifth baby home at twenty-eight hours, which was considered "early discharge" at the time, but is routine by today's standards. Despite being a fully trained pediatrician and an experienced mother, I recall becoming worried and upset several hours later. My baby was beginning to look jaundiced and I realized he hadn't urinated since earlier that morning. Why had I insisted on leaving the hospital so early? I was tired and overwhelmed with four other excited children between two and seven years of age. I could have used a word of encouragement and a second opinion from an experienced nurse right about that time. Suddenly, I wished I had stayed in the hospital longer or could check myself back in.

Fortunately, my baby awoke a short time later, nursed well, and wet his diaper. I decided he didn't look very jaundiced after all, and I could tell my milk was starting to increase. While my own anxiety quickly subsided, I tried to put myself in the place of less experienced parents who might face a more prolonged period of insecurity after leaving the hospital. This chapter is devoted to giving you the information you need to remain confident about breastfeeding once you're on your own at home and to set the stage for the long-term success you desire and deserve.

Home Alone with Your Breastfed Infant
Your first days and weeks at home with your new baby are a precious, yet precarious, time. You'll probably alternate between feeling confident and overwhelmed, overjoyed and anxious, exhilarated and exhausted. Initially, learning to care for and getting to know your baby is a full-time job. Breastfeeding will consume the most hours in your day, and will be the most intimate and, if all goes well, the most satisfying aspect of new motherhood. Getting breastfeeding off on the right foot is one of the most important things you can do to smooth your adjustment to new parenthood.

Make Nursing Convenient and Comfortable
At first, most of your nursings will probably occur in a few specially chosen locations around the house, such as your bed, the living room sofa, or a rocker in the baby's nursery. While you and your infant are learning the art of breastfeeding, a convenient and comfortable location is important. For first-time mothers, privacy may be a priority, while those with small children often prefer a central location. Eventually, you'll find you can nurse with ease almost anywhere. In the beginning, however, the setting for your nursing stations, or nursing nooks, can make a big difference. Plan to have several pillows and cushions, as well as a footstool, on hand.

To simplify your duties during the first few weeks, keep a supply of clean diapers, infant wipes, and extra infant clothing on a table nearby, so you can feed and change your baby without having to leave your nursing corner. You also will want to stock your area with some enjoyable reading materials for leisurely nursings. (Yes, you eventually will be able to breastfeed without feeling like you need a third hand.) If you have older children, fill a basket or box with a few favorite toys and storybooks to occupy them in your presence while you nurse. Finally, keep a tall glass of water or a filled sports bottle handy to allow you to sip fluids while you breastfeed.

Despite all the effort that went into the preparation of your baby's nursery, she'll probably be more content in a bassinet at your bedside during the early weeks at home. Night feedings will be less disruptive if you can just reach over and bring your baby into bed to nurse. I found a large overstuffed reading pillow with armrests to be a godsend. I kept the cushion propped against my headboard and just sat up in bed and leaned back against it while I nursed in the middle of the night, half-asleep. With a stack of diapers on the nightstand, I could change my baby, often without getting out of bed, and return him or her to the bassinet with minimal fanfare.

Page 2Enlisting Support
Breastfeeding is easier when you have a strong support system. Ideally, your partner will be prepared to fulfill many aspects of this important role. Maybe your mother or your mother-in-law or a sister might also be able to help out for a period of time. This helper role is so critical that it is known by a specific name in many cultures and some animal societies. The term doula describes the one who "mothers the mother." This individual serves as the primary source of nurturance and support for the new mother, thus enabling her to fulfill her role as principal caretaker of the infant. Today, it is possible to hire a professional doula to nurture postpartum women and ease their transition to new motherhood.

I have served as a doula myself and expect to do so again many times when my grandchildren are born. On eight occasions, I have had the privilege of being present for several days when my sisters or sisters-in-law brought home new babies. As a result of these experiences, I have concluded that easing the adjustment of vulnerable new parents is a daunting task. Your helper's mission is to jump in and do whatever seems necessary at the moment, to defuse inevitable tensions, to offer advice without undermining the new parents' efforts, to keep a low profile, to serve as a sounding board, and to provide a continuous infusion of emotional support.

If possible, arrange for a friend or relative (preferably one who has breastfed her own babies) to come and stay with you for a week or so. At the least, try to have such a person available during the daytime or consider hiring a professional doula. Ask your partner or other helper to ease your burden by bringing the baby to you for nursings, offering you a beverage, burping and changing the baby after feedings, insisting that you nap, preparing meals, occupying an older child, doing laundry, keeping visitors at bay, and bolstering your spirits.

Don't invite relatives, no matter how well intentioned, with whom you are not completely comfortable, who tend to be hypercritical, or who aren't likely to be genuinely helpful. Now is not the time to feel like you need to entertain someone or put on a good display. Instead, choose a helper with whom you can let it all hang out, perhaps your sister or mother. Surround yourself with like-minded relatives or friends who can be counted on to encourage you and assist you in every way possible. Even if you have no one who can help you in your home, you can obtain support over the telephone by calling the hospital nursery, your doctor's office, an experienced friend, your local WIC program, or a peer support group.

Restricting Visitors
During your get-acquainted period with your baby, keep visitors to a minimum except for those who truly will help. I have witnessed firsthand how a steady stream of visitors inevitably interferes with unrestricted breastfeeding. Nursings easily get interrupted or postponed because of the presence of guests. Discourage drop-in visits. Use your telephone answering machine or ask your partner or doula to screen calls. Have them protect you with comments like "She's with the baby now," or "She's finally napping and I don't want to disturb her," or "The doctor insists that we delay visitors for at least a week or so." I recommend an intimate family honeymoon when bringing your new baby home and launching your breastfeeding. Once your baby is nursing well and gaining weight steadily, you'll have more time and energy to receive visitors and truly enjoy their company.

Getting Enough Sleep
In the first postpartum weeks, sleep deprivation and sheer fatigue plague all new parents. The burden of night feedings, the enormity of baby care, and physical depletion after delivery take their inevitable toll. Remember, exhaustion can make your entire situation seem bleaker, while a little rest can change your whole perspective and improve your outlook. Many parents make the mistake of coming home from the hospital and diving into projects like finishing the nursery, lining the baby's dresser drawers with contact paper, writing birth announcements, completing work assignments, and so on. Your top priority when you aren't feeding your baby or doing other essential care is simply to rest and sleep. Since your nighttime sleep will be interrupted, you need to get in the habit of napping when your baby naps. Wearing your bathrobe during the day may serve as a physical reminder to slow down and rest. Once breastfeeding is going smoothly and a daily routine begins to emerge, you can find time to get other things done. In the first few weeks, however, rest and sleep should take precedent over any other activity you think you "ought to do."