Breastfeeding is the optimal way to feed your baby because breast milk is always available at the right temperature, doesn’t need any mixing or equipment, costs very little and helps protect your baby from common early childhood illnesses such as colds, ear infections, and diarrhea, especially during the early weeks and months of her life. The ideal goal is to breastfeed for at least the first year, but your baby will benefit from whatever amount of breast milk they receive.
Techniques for the Breastfeeding Mother
The way your baby “latches on”, or attaches to your breast, is one of the most important things to master for successful breastfeeding both to prevent or minimize sore nipples in you and to ensure adequate nutrition in the baby. Gently lift and support your breast, with your fingers below the breast and your thumb above, well away from the areola (the dark area around your nipple). Gently stroke your baby’s bottom lip with your nipple in a downward motion several times until your baby opens his mouth very wide. Then quickly pull him onto your breast so that his nose, cheeks, and chin are all touching the breast and most of your areola should be in the baby’s mouth. Your baby’s face, tummy, and knees should be facing you, in a snug tummy-to-tummy position. See the pictures below.
Place your thumb and fingers around your areola.
Tilt your baby's head back slightly and tickle her lips with your nipple until she opens her mouth wide.
Help her "scoop" the breast into her mouth by placing her lower jaw on first, well below the nipple.
Tilt her head forward, placing her upper jaw deeply on the breast. Make sure she takes the entire nipple and at least 1 1/2 inches of the areola in her mouth.
Babies should be offered both breasts at each feeding. When your baby loses interest in the first breast, stop and burp him, then offer the second breast. To change breasts, put you finger into the corner of the baby’s mouth between the gums, and he will open his mouth, releasing the suction. Let your breast completely air-dry after nursing.
If you need to be separated from your baby at feeding time, you can leave behind a bottle of pumped/expressed breast milk.
A healthy, full-term newborn who is breastfeeding well at least eight times a day should need no feedings other than mother’s milk. Your baby is most likely getting enough milk if:
- Your milk “comes in” in increasing amounts (engorgement) – usually by 2nd – 4th day. This fullness is decreased after feeding
- Your baby has no difficulty latching on.
- She is breastfeeding every two to three hours for 10 minutes or more on each breast
- You can tell when she is hungry and demanding feeds and that she is satisfied after feeds
- You can hear a rhythm of suck/pause/suck during feedings.
- She has at least one wet diaper per feed.
- Your baby is passing, yellow, seedy runny stools, starting on day 3 or 4.
An ideal breast pump, especially for the mother that has long periods of separation from he baby, is one with a double pumping kit so you can pump both breasts at once and cut the time in half that you will need for expressing milk. If you need to be separated from your baby only occasionally, a hand pump or hand expression may suit your needs. Several different types of breast pumps are available:
Hospital grade electric pumps produce the closest imitation of both the pressure and rhythm of a baby’s sucking action.
A double pump set-up - These pumps may expensive to purchase, but they are available for rent on a weekly, monthly, or longer basis from hospitals or medical supply companies.
Small hand-held battery or electric pumps are most appropriate for a limited amount of pumping, as when you collect for an occasional separation from your baby.
The following are the basic procedures for storing and handling your milk:
- Always wash your hands before handling milk
- Transfer your expressed milk into a clean glass or rigid plastic, food-safe container or heavy-duty breast milk bag for storage.
- Label the container with the date and time the milk is collected so you can be sure to use the oldest milk first.
- Freshly expressed milk contains antibacterial factors that enable it to be kept at room temperature for up to 4 hours.
- If you intend to store your breast milk for longer periods of time, freezing your breast milk is preferred. Freeze your milk within 24 hours after it has been expressed. Refrigerated breast milk should be used within 24 hours if possible.
- Freeze your milk in small (2- to 4-fluid-ounce) portions so that they will thaw fairly quickly and they are portioned for feeds. This will also minimize waste.
- Wash all the pump parts that come into contact with your breast milk and any storage containers in hot, soapy water after each use; rinse well in hot water.
Guidelines for storing breast milk for healthy, full-term infants†
In Refrigerator
In Freezer
Freshly expressed breast milk
Use within 24 hours if possible
Discard after 72 hours
Up to 1 month in freezer compartment of refrigerator
3-6 months in deep freezer (0°F or less); store in the back of the freezer. Label and use oldest first. Best if used within 3 months.
Previously frozen breast milk
24 hours
Never refreeze
Guidelines for thawing frozen breast mik†
DO
DO NOT
Thaw container of frozen breast milk gradually, in the refrigerator, under increasingly warm running water, or in a bowl of warm water.
Defrost breast milk by using boiling or very hot water.
After the thawing is complete, gently swirl the container to mix the milk before feeding it to the baby, because the milk can separate while standing.
Defrost breast milk in a microwave oven. Uneven heating may cause “hot spots” that could burn your baby. Also, microwaving may alter proteins and destroy some protective components of the milk.
†Adapted from Keek JY (ed): New Mother’s Guide to Breastfeeding. Elk Grove, Ill: American Academy of Pediatrics, 2002.
Tilt your baby's head back slightly and tickle her lips with your nipple until she opens her mouth wide.
Help her "scoop" the breast into her mouth by placing her lower jaw on first, well below the nipple.
Tilt her head forward, placing her upper jaw deeply on the breast. Make sure she takes the entire nipple and at least 1 1/2 inches of the areola in her mouth.