by Victoria Macioce-Stumpf, ICCE, CD(DONA)

• Colostrum (the first breast milk a mother produces) is the most easily digested, nutritiously superior substance a newborn can receive-- it contains antibodies against various bacteria and viruses and provides protection to the baby against anything that mom has been immunized against (ex. Polio, measles, etc).

• Colostrum has an enzymatic effect to break down mucous in the baby’s digestive tract.

• Colostrum has a laxative effect on meconium in the newborn’s bowels.

• Breastfeeding promotes mother/baby bonding.

• A breast-fed baby is less likely to have allergies or asthma.

• Breastfeeding promotes excellent physiologic development of the baby’s jaw, teeth and gums.

• Breastfeeding helps the mother’s uterus involution (shrinking down to it’s pre-pregnancy size) occur more quickly which helps her stomach to shrink back down.

• There is no preparation, heating, refrigeration, storing or sterilization required.

• There is a significant cost savings over bottle feeding, which requires bottles, formula and supplies.

MECHANICS OF BREASTFEEDING

Alveoli produce milk in myoepithelial cells, Ducts transport milk to reservoirs, Reservoirs (sinuses) lead to multiple openings in the nipple. The Areola is the brownish/reddish circle that surrounds the nipple.

HOW TO POSITION THE BABY

Cradle hold/ Sitting Position (tummy to tummy) - Mom sits supported by pillows at her lower back and arms, elevates the baby on a pillow to relieve any strain on her arms, the baby’s body forms a "C" shape with his feet tucked around Mom’s body (tummy to tummy), she cradles baby’s head in the crook of her arm, tucks the baby’s lower arm around her body (under her elbow), centers the baby’s wide open mouth over the nipple/areola and begins feeding.

Football hold-baby’s bottom rests on pillow near Mom’s elbow, baby’s feet tucked under her arm, and baby’s head is cradled in her hand. Mom leans forward and centers the nipple/areola in baby’s mouth, and then settles back comfortably.  This is the best position for the baby's first breastfeeding, so that Mom can see the baby's mouth and position the baby properly. 

Side-Lying Position- Mom is laying on her side comfortably supported with pillows. Baby is placed on his side facing Mom with a rolled towel behind his back for support, and the nipple/areola is centered and guided into the baby’s mouth.

PROPER LATCH ON AND OFF THE BREAST

To latch the baby ON your breast, press gently on baby’s chin to help open his mouth wide enough to get most of the areola into his mouth (be sure his lower lip is turned out and not rolled in over gums). The baby’s tongue should be under the nipple. To take the baby OFF your breast, slip a clean finger (with the nail trimmed) into the baby’s mouth between his gums to release the suction.

ROOTING REFLEX- Stroke your baby’s cheek with your nipple or a clean finger. The natural response is your baby will open his mouth in the direction of the cheek that is being stroked and try to grasp your nipple. You can "tickle" the baby’s lips with your nipple to stimulate the same response.

SUCKING REFLEX- This reflex simply refers to the instinctive response of most newborns to suck on an object placed in its mouth. Most newborns are born with a sufficient sucking reflex, but if your baby’s reflex is weak, you can try to stimulate this response with your clean finger.

LET-DOWN REFLEX- Your baby’s suckling stimulates your Hypothalamus gland in your brain, which in turn stimulates your Pituitary gland, which causes the release of the hormones Oxytocin (which contracts the alveoli in the breast to release the milk) and Prolactin (which stimulates the breast to produce milk). A tingling sensation, a full feeling in the breast, or a bubbly sensation may be noticeable during this reflex. If you are watching your baby before the let-down reflex occurs, you may notice a pattern of "suck, suck, suck, swallow". After the let-down reflex, you may see instead "swallow, swallow, swallow, swallow" as the baby takes in the milk which is being ejected from your nipple.

SUPPLY AND DEMAND FEEDINGS 

The breast is never truly "emptied", so there is always milk for the baby. The more the baby sucks, the more milk is produced on the spot. The longer the baby nurses, the more "hindmilk" the baby receives, which is richer in fat and calories and helps the baby grow.

HOW LONG AND HOW OFTEN SHOULD FEEDINGS BE

Mom should be following baby’s cues-- the baby nurses most vigorously on the first breast offered. Once the baby slows down or stops (usually about 15-20 minutes), take the baby off, try and stimulate (by burping, tickling the baby's feet, etc.) and offer the breast again.  

If you'd like, you may switch to the other breast, but it isn't necessary to switch breasts at each feeding.. Let the baby nurse until he stops or falls asleep. His little tummy is approximately the size of a golf ball, but it takes him approximately 30-60 minutes for a good feeding.  It is more important to watch the baby and make sure he is actually getting "let-downs" and has a good swallowing pattern, not simply how many minutes he is at the breast.  The next feeding should begin on the same side the last feeding ended on.

HOW TO CREATE AND MAINTAIN A GOOD MILK SUPPLY 

Let the baby nurse well and often-- every 2-3 hours is typical for a newborn. Take good care of yourself--drink plenty of fluids, eat an extra 200-500 calories per day, and try to rest as much as possible when the baby sleeps in the first few weeks of your baby’s life. Make certain the feedings are long enough (see above) and the milk supply will take care of itself. Remember, it is the baby’s nursing that creates and maintains your milk supply, so you ALWAYS have "enough" milk. Follow your baby’s cues........watch your baby and not the clock. Sometimes, a baby will feed in batches--several feedings in a few hours--and follow that with a good stretch of sleep.

Your baby should be wetting or soiling 6-10 diapers each day, have good skin color (healthy, not pasty), and your baby should NOT be listless or have a weak-sounding cry. The best test of all is consistent weight gain.

GROWTH SPURTS 

Every few weeks or so in the first 4 months, your baby may experience a few days at a time where his appetite seems measurably increased. Your baby may eat and sleep much more than usual, and then after a day or two, go back to previous eating and sleeping habits.  It is important to follow your baby's cues and feed upon demand.  Your supply will keep up with your baby's demand.

Wear clothing that is easy to breastfeed in-- sweaters or tops that can be pulled up. If you are wearing a shirt that is buttoned, open it from the BOTTOM buttons first, until you open only half the shirt. Move one side out of the way, and begin nursing. If you wish, you may put a receiving blanket over your shoulder and the baby’s head, but it isn’t necessary. It is usually more discreet to use the blanket under the baby which is over your bared abdomen from where your shirt is lifted up. Practice nursing discreetly until you feel comfortable breastfeeding in public-- most people will assume the baby is sleeping in your arms, not necessarily that he is being fed. Most of all, be proud of the wonderful gift you are giving your baby, and the wonderful example you are setting for all current and future breastfeeding mothers everywhere!

A Mother-and-Baby Honeymoon:

We usually think of a honeymoon as a time of privacy for a husband and wife but, in many cultures, the tradition of undisturbed intimacy applies also to a mother and her baby immediately after the birth. The Wayapo tribe of Brazil observe a "moon-long" seclusion for newly delivered mother and child, during which time they bond with one another and learn each other’s shapes and smells. 

In India, according to ancient Ayurvedic principles, new mothers are looked after in their homes for the first twenty-two days after the birth. During this period, the mother-infant bond develops as the mother remains focused only on nurturing, holding, stroking, and generally getting to know her baby. Breastfeeding develops smoothly and naturally, free from any pressure to clock-watch.

--from "With Child--Wisdom and Traditions for Pregnancy, Birth and Motherhood" by Deborah Jackson. (All rights reserved)

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