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Answers to Breastfeeding Questions

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Answers to Breastfeeding QuestionsNew mothers want to know how often they should breastfeed. When your baby is just learning to nurse, it's best not to think about how far apart to space "feedings." The very term implies meals being consumed at predictable intervals. But an early breastfeeding session is less a meal than it is a learning experience that needs to be repeated at frequent intervals.

You and your baby each have a lot to learn, and the way you learn is by practice. You are learning how to position your baby and how to present your breast. Your baby is learning how to correctly grasp your nipple and areola, how to extract milk, how to suck and swallow and breathe without choking, and how to soothe and pacify herself at your breast. Until your milk comes in abundantly on about the third day, your baby may obtain only a couple of teaspoons of milk when she nurses. Instead of waiting an arbitrary number of hours between feedings, plan to offer your breast as often as your baby shows interest (see Infant Signs of Readiness to Feed below) in order to give your baby as much breastfeeding practice as possible. Expect to nurse your baby at least eight, and as many as twelve, times each twenty-four hours during the first month. If your baby doesn't wake or demand to nurse after about three and a half hours have elapsed since the beginning of the last feeding, you should try to arouse her. Ideally, your baby will be with you in your hospital room, but if she must stay in the nursery, request that she be brought to you whenever she stirs.

Infant Signs of Readiness to Feed
Many new parents expect their baby to cry when she is hungry. Few realize that crying is actually a late sign of readiness to feed. If you wait until your baby is crying loudly before you prepare to nurse her, both she and you may experience unnecessary frustration if you are unable to satisfy her need fast enough. Worse yet, some babies become exhausted from crying too long and end up nursing poorly by the time they are brought to the breast. Instead of waiting for your baby to cry, look for earlier, more subtle clues that she is ready to nurse. Babies signal readiness to feed during arousal from sleep, by increased alertness, flexing their extremities, bringing a hand to their mouth, turning their head, or moving their mouth or tongue. One or more of these signs can usually be observed long before the baby cries out loud.

Early Infant Elimination Patterns
The first bowel movement your baby passes, known as meconium, will look tarry black and is present in the baby's intestines during fetal life. Because colostrum is a natural laxative, frequent nursing will help expel the meconium. During the hospital stay, your baby's stools may change to a greenish-black. As the volume of milk your baby drinks increases, his bowel movements will turn yellow-green. By the fourth or fifth day, they should look yellow-gold, with little seedy curds, and the number of movements should increase to four or more each day.

Your baby may urinate only a couple of times a day on the first two days when the volume of colostrum he drinks is low. Once your milk increases in abundance (around the third day), he obtains a greater volume with each feeding, and the number of wet diapers increases to six to eight each day. Begin during your hospital stay to notice your baby's elimination habits. Keeping a record of your baby's feeding times, wet diapers, and bowel movements can be very helpful in monitoring his progress with breastfeeding.

Burping Your Baby
All babies swallow some air during feeding. Although many will burp easily without any special positioning, most parents make a ritual of helping their baby burp after taking the first breast and at the end of the feeding. A few babies need to be burped more often to remain comfortable. Trapped air in the stomach can cause a baby discomfort, making him restless partway into the feeding. Releasing the air may allow a baby to proceed with feeding more comfortably. A bubble of air in the stomach also can make a baby feel full too soon and cause him to stop feeding before he has taken enough milk. Burping the baby after the first breast not only makes room in the stomach for more milk, but the positioning and handling involved in burping can help arouse a sleepy infant to take the second side.

If your baby is sucking well, don't interrupt him to burp. Rather, take advantage of natural pauses for burping and use the time to socialize with your baby as you gently pat and stroke him.

Several good techniques are suitable for burping your baby. My favorite position for burping a newborn is to sit the baby upright on your lap, with your hand cupped under his chin to support his chest and head. Lean him forward slightly while you rub and pat his back. If he doesn't burp after a few minutes, you don't need to persist in your efforts. Another popular position is to support your baby upright over your shoulder (protected with a cloth diaper) and pat his back. Or you can lay your baby across your lap, with his head slightly higher than the rest of his body, and gently rub and pat his back.

Page 2Clothing
When you first start to breastfeed, adequate exposure of the breasts will make it easier for your baby to latch on correctly. You'll have plenty of time later to learn to nurse discreetly. It helps in the beginning to wear a gown that opens in the front. Those lovely nursing gowns with the slits for exposing your breasts will serve you well once breastfeeding is going smoothly. In the beginning, however, clothing often gets in the way of your baby's efforts to latch on. It's best to forgo modesty in favor of technique. Pull the curtain around your bed or ask the nurse to put a Do Not Disturb sign on your door if you are concerned that someone might enter your room unannounced while your breasts are exposed. You are not expected to nurse in the presence of anyone who makes you uncomfortable. During the learning stage, feel free to ask anyone to step out of the room if you feel awkward in their presence. Eventually, most women become comfortable nursing almost anywhere without feeling self-conscious, but you probably won't want an audience when you and your baby are still figuring things out.

Drink a Beverage While You Nurse
Another good habit you will want to start before you leave the hospital is making sure you have something available to drink each time you breastfeed your baby. Milk production requires extra fluids, and nursing mothers get thirsty often. Let your friends and relatives help out by getting you a glass of water or juice. Placing a straw in the glass will make it easy for you to take a drink when the glass is offered, since at first both your hands will be occupied during nursings. Many breastfeeding mothers find that the habitual practice of drinking a beverage as they prepare to nurse also helps to trigger their let-down reflex.

Night Feedings
Don't make the mistake of bypassing night nursings so you can get extra sleep in the hospital. Night nursings are important to your baby and to you. No one gets much sleep in a hospital whether or not they feed their baby at night. The best way to assure that you get the maximum possible sleep in the long run at home is to leave the hospital knowing how to feed your baby. A breastfed baby who is kept in the nursery and bottle-fed by the nurses at night may not nurse as well when the mother desires to resume breastfeeding in the morning. Today, hospital stays are so short that mothers can't afford to miss even one opportunity to practice their breastfeeding technique before they go home. Don't view night nursings as an inconvenient interruption. Doing the feedings yourself at night ultimately benefits you and your baby.

Learn All You Can in the Hospital
During your brief hospital stay, there's so much to learn about baby care that it's hard to take it all in. Still exhausted from labor and delivery, you may be tempted, indeed encouraged, to delegate as much care as possible to the nurses. But remember, although the nurses may give expert care for the moment, they're not coming home with you! Your top priority in the hospital is to transfer as much of the nurses' expertise as possible to yourself and your partner before you take your baby home. Let the nurses know that you want to do much or all of your baby's care so you will be prepared to "go it alone" after discharge. Don't be afraid to ask even the most basic questions. Plenty of mothers have asked the same thing before you!

Closed-Circuit TV
Many hospitals have educational programming for new parents on closed-circuit TV. Such programming ranges from in-house productions aired at specific times to continuous commercial programming aimed at new parents. I am amazed how often the TV is on when I enter a patient's room. We certainly are a visually oriented society, and TV viewing is an integral part of daily life. Instead of watching your favorite soaps, talk shows, sitcoms, or drama features, vow to use the TV for educational purposes until you are comfortable in your new parent role. Baby care and breastfeeding videos won't substitute for one-on-one guidance from an experienced nurse, but the information you gain from watching these programs will make your interactions with the nurses even more worthwhile.

Classes
Many hospitals offer group instruction, such as bathing demonstrations or infant-feeding classes before discharge. Make every effort to take advantage of such instruction before you go home. Some hospitals offer classes a few days after discharge, when parents often are even more receptive now that they are "flying solo."

One-on-one Instruction
Reading materials and videos are valuable resources, but when it comes to latching your baby on, it really helps to have an experienced professional at your side. While you are in the hospital, ask for personal, expert assistance as often as you need it. Before you are discharged, ask a knowledgeable nurse to observe your breastfeeding technique to make certain you can correctly position, latch, and nurse your baby on your own at home.

Breastfeeding Specialists
Many hospitals that offer maternity services have a breastfeeding specialist or lactation consultant on their staff. Sometimes this individual is able to meet and assist every breastfeeding mother on the ward. In other hospitals, she might be called upon to help only those women having difficulties. Ask whether your hospital has a lactation consultant and don't leave without getting her phone number! If you are having any difficulties, ask to be seen by the specialist. Often, these experts are able to continue to help women on an outpatient basis after they are discharged.