Nursing Know-How

As rewarding as breastfeeding can be, it's not always easy for new moms to figure out.

A Learned Art

One of the biggest myths about breastfeeding is that it comes naturally for both mothers and infants. Yes, a baby's sucking reflex is instinctive. "But breastfeeding is a learned art," says Katy Lebbing, manager of the Center for Breastfeeding Information at La Leche League International. "Many women rely on hospitals to teach them, but hospitals often don't devote much time to educating moms about breastfeeding."

To help you succeed, we asked top lactation consultants for their most important advice.

It Shouldn't Hurt to Nurse

"No woman should ever be told that pain is normal," says Marsha Walker, RN, former president of the International Lactation Consultants Association. Severe pain can mean either your baby isn't latched on right or that he's not sucking correctly. (Pain can also be a sign of infection, so be sure to get it checked out as soon as possible.)

Expert tip: Some tenderness is normal in the first two weeks. Ease the discomfort by applying a little bit of expressed breast milk onto your nipples and areola after each feeding. But if you're in a lot of pain, stop breastfeeding until you talk to a lactation consultant or your doctor. An improper latch for even a brief period of time can damage your breast tissue.

If your nipples are cracked and sore, check your baby for signs of improper sucking. If there's no evidence that she's rhythmically sucking and swallowing milk (her ears should move slightly and you will usually hear swallows), something's not right. If your nipple is creased horizontally or vertically or has a white line, it means your baby's been biting it.

Expert Advice

Some Babies Need More Time

Sometimes it takes a bit longer for a newborn to latch -- and the most common reason is that the baby's sleepy because his mother was given an epidural or other labor medications. "Research has shown that if an epidural is administered for more than two hours, you'll have latching problems," says Lebbing. "The longer the epidural is in, the more likely you are to have trouble. I once saw a woman who'd had an epidural in for 48 hours; her baby didn't latch on for three weeks."

Expert tip: If your newborn isn't latching on during feeding sessions, don't let her sleep in her hospital bassinet. Instead, place her on your chest and watch for feeding cues such as squirming, sucking movements of the mouth and tongue, and rapid eye movements, says Walker. "Those are signs that she's entered a lighter sleep state and she'll be more likely to latch on," she explains. Even though your milk won't come in until three or four days after the baby's birth, it's important to start nursing right away because your breasts are full of colostrum, a form of milk that contains important nutrients to protect your baby from infections.

Get the Flow Going Early

Breastfeeding a lot during the first couple of weeks will help ensure you have an abundant milk supply. Studies have found that in the early weeks of nursing, a mother's breasts make prolactin receptors. (Prolactin is a hormone that helps you produce milk.) The more frequently you nurse, the more receptors will be made, so you'll have adequate milk down the line.

Expert tip: "The biggest mistake women make is not waking their newborns up to nurse," says Lebbing. You should feed your infant every two to three hours, waking him up if you need to. If he isn't emptying your breasts, you should pump and freeze your milk for later use. If you're unable to breastfeed (for example, if your baby is sick or preterm), you should pump about 10 times every 24 hours during the first 14 days.

Preemies Can Get Breast Milk Too

If your baby is born prematurely or has a health problem and can't breastfeed right away, make sure you start expressing breast milk no later than six hours after delivery.

Expert tip: Try manually expressing at the beginning. Colostrum is thicker than the milk that comes in later on. "When you use an electric pump, colostrum doesn't flow as well," says Walker. Label what you pump by date and with your baby's name and store it in the freezer. When your baby is ready, feed it to him in chronological order.

Keys to Latching

Give your baby a little extra help latching on with these easy breastfeeding tips.

  • Position your baby so his nose is in front of your nipple.
  • Support him with your fingertips behind both his ears and your other arm resting along his spine.
  • Gently tickle your baby's lips with your breast.
  • When your baby opens wide, do not aim the center of his mouth toward your nipple. Instead, aim his lower lip toward the areola, about an inch away from the nipple. This slightly asymmetrical aim will ensure the nipple ends up toward the roof of your baby's mouth and will enable him to compress the breast tissue with his tongue -- which he needs to do to get milk.

Gear Guide

Products that will make breastfeeding...

...less painful

These packs can provide either warm or cool therapy for sore breasts.
(SkinVestments Bosom Buddy, $20, goores.com,)

...more comfortable

With the proper support, you can nurse your baby without straining your arms or back.
(Boppy Nursing Pillow, $50, boppy.com)

...and discreet

Feel free to nurse anywhere with these cool covers that come in funky designs.
(Modest Mommy Nursing Cover, $30, modestmommycover.com)

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