How to Breastfeed
Successful breastfeeding takes time, patience and practice. Correct positioning and attachment are essential.
It is normal in the first 7 to 10 days for the nipples to be tender whilst breastfeeding is established. The area in and around the nipple is full of nerve endings which stimulate the brain to ‘let-down’ the milk.
Sore nipples that continue into the breastfeed are not normal and the main reason for the pain in the early days is generally attributable to incorrect positioning and latching.
Positioning
Hold the baby close. This may mean having to remove some blankets, or bulky clothing. A baby will not get cold when held close to its mother’s body
Tummy to tummy and nose opposite nipple. If a mother can see her baby’s tummy button the baby is not turned sufficiently towards her to help them latch well. The best way to describe this is – tummy to tummy. Support the baby with their nose opposite the nipple – smelling the milk with help the baby to do all the right things with their mouth to achieve a latch
Cross cradle position. It is often easier to start breastfeeding by holding the baby in the cross-cradle position. This means the baby’s head is supported with the mother’s hand around the base of the neck.
If a baby is going to feed on the left breast then hold them with the right arm supporting the baby’s body and the right hand around the base of the neck. The left hand thumb can be used to gently pull the nipple upwards so it is pointing towards the baby’s nose.
Mothers with larger breasts can support their breast with the left hand but need to make sure all fingers are well away from the areola or the baby may not be able to latch if a finger is in the way.
Baby’s natural head tilt. The positioning of the mother’s hand is important as the baby has to be able put their head back slightly. Babies do this little head tilt by themselves as it helps them come to the breast with the chin first rather than being squashed into the breast with the nose and chin together. Therefore it is important for a mother to make sure her arm or hand is not behind the baby’s head and preventing this physiological movement
Adjusting to a cradle hold. Once a baby is latched well mothers can adjust their position to a cradle hold, to make it more comfortable, by releasing their hold with their left hand on their breast (unless it is very heavy and full – in which case they may need to support it during the feed*) and move their arm gently around the baby
Latching
Approaching the breast. Bring the baby gently towards the nipple and touch the baby’s top lip with the nipple then move the baby slightly away again gently.
Repeat these movements quietly and gently until the baby opens wide or run the nipple very gently along the baby’s top lip (not the bottom lip or baby may latch suddenly on to the nipple and squash it).
Wide open mouth. A baby has to have a wide open mouth and their tongue forward to latch correctly. It is not possible for the baby to latch unless these things happen.
Don’t rush the baby and don’t try and pull the baby on or try and push the nipple in the baby’s mouth without this very wide mouth happening.
If the baby is not bringing her/his tongue forward when the mouth is wide enough for a latch try hand expressing a little milk into the baby’s mouth to encourage the tongue to come forward.
When the baby opens wide and brings the tongue forward they may latch by themselves if close enough to the breast but the mother may have to quickly bring the baby to the breast when the baby is ready – this has to be quick or the baby may close her/his mouth again.
Don’t worry if the wide mouth is missed a few times – mother and baby are both working it out together and it takes practice
How much of the areola does the baby need to latch onto. The baby’s nose should be level with the nipple. It may sound odd to hear advice to point the nipple upwards rather than straight into the baby’s mouth. Because more of that darker area or areola under your baby’s bottom lip needs to be grasped by the baby, the nipple needs directing upwards towards the top of the baby’s mouth or in the direction of her/his nose
A baby needs more of the areola (darker area around the nipple) underneath their bottom lip than the area above their top lip. A mother will see areola above the baby’s top lip when she looks down after the latch and during a feed and that is normal. Someone may say (or books may state) that a baby has to take as much of the areola into their mouth as possible to latch properly. This is a misleading piece of advice.
Once the baby is attached
The baby’s chin will be touching the breast but her/his nose should be reasonably clear.
The baby’s bottom lip will be flanged outwards and not turned inwards.
The baby will start by sucking quite quickly but when the milk starts to flow will change to rhythmic longer sucks with some short pauses. Mothers will also start to hear some swallows which will increase once the milk comes in and starts to flow more.
The baby’s cheeks should stay rounded when sucking. A dimpled look is usually a sign of an incorrect latch.
Funny little clicking noises during sucking may also be a sign that the baby needs to take more of the breast tissue into the mouth.