How to Breastfeed
Most experts recommend that nursing mothers breastfeed as soon as possible (e.g., within 2 hours) after giving birth. It normally takes a few days for true lactation to begin and during this time the infant receives colostrum, which is gentle on the digestive system and provides important antibodies.
Most newborns nurse 8 to 12 times per day and should be fed on demand. Signs of hunger include being alert and active, "mouthing" (putting the hands to the mouth), and "rooting" (turning the head to locate the nipple). Newborns often sleep as many as 18 hours a day and often must be awoken for feedings.
During the first couple of days, nursing infants may have only 2 wet diapers a day, but after the milk supply has been established, 5 - 6 wet diapers and 3 - 4 soiled diapers a day is about normal. In newborns, the stool usually is thick, tarry, and dark in color for the first few days, and then becomes watery, light in color (e.g. greenish yellow or mustard-colored), and seedy in consistency.
Breastfeeding may cause tenderness, but it should not hurt. In most cases, any tenderness improves gradually during the first couple of weeks. If nursing becomes painful, contact a lactation consultant or a breastfeeding support group. After the milk comes in (usually 2 to 5 days after giving birth), the breasts may feel full and leak. Disposable or cotton pads may be worn inside the bra to absorb leaks.
When the mother's milk comes in, her breasts may become swollen, hard, and painful (called engorgement). If this occurs, a breast pump may be used to remove a little breast milk between feedings and ice packs may be used to reduce swelling, pain, and inflammation.
It is important to hold the infant in a comfortable position during breastfeeding. The baby should be held with his or her whole body facing the mother and should not have to turn his or her head to nurse. Many women find that it is helpful to use pillows for support. A receiving blanket or small towel can be draped over the infant and the mother's shoulder to provide privacy.
It also is important for the infant to latch on to the nipple and the areola, rather than just the nipple. If the infant is not latched on properly, break the seal by gently inserting your finger into the corner of his or her mouth, and then reposition the baby and try again.
In most cases, breastfeeding provides exactly what infants need for healthy growth and development during at least the first 6 months to 1 year. The amount of breast milk that is produced is regulated by the needs of the infant.
Signs that the baby is receiving adequate nutrition through nursing include steady weight gain (although it is normal for a newborn to lose about 7 percent of his or her body weight during the first 3 - 5 days after birth), light-colored urine (rather than dark-colored), periods of alertness, and sleeping well.
Pumping and Storing Breast Milk
Pumping and storing breast milk can allow nursing mothers to return to work and/or experience time away from the infant while continuing to nurse. It also can provide opportunities for another caregiver (e.g., father, grandparents) to feed the infant.
A manual or electric breast pump can be used to remove breast milk to be fed to the infant at a later time. Breast milk can be stored in the refrigerator in a sterile, sealable container, such as a plastic or glass bottle or a Ziploc bag). Many experts recommend that artificial nipples, such as a bottle or pacifier, not be used for about the first month so they don't interfere with the baby's ability to learn how to breastfeed.
It may be helpful for women to practice pumping for a week or two before returning to work. Some women pump just after nursing, and others pump between feedings. Pumping takes about the same time as breastfeeding; however, with an electric pump, it may take as few as 10 - 15 minutes.
It is normal to produce little milk at first, but after a few days, most women begin producing more breast milk. Making sure to drink plenty of fluids, pumping frequently throughout the day (at least for about 15 minutes every few hours), and providing extra feedings whenever possible can help increase milk production.
Breast milk that is not used right away should be placed in the refrigerator or frozen. It may be helpful to store the milk in amounts that the infant typically eats during each feeding. For example, if the baby eats about 4 ounces, store about 4 ounces of breast milk in the bottle or container.
Breast milk that is frozen can be thawed by placing the container in warm water until thawed, or by putting it in the refrigerator for up to 24 hours. Breast milk should not be thawed or heated in a microwave oven and frozen breast milk that has been thawed should never be refrozen. In general, use breast milk kept at room temperature within 8 hours; use breast milk that has been refrigerated within about 1 week; and use breast milk that has been frozen within 3 months.
Contact your pediatrician, another qualified health care provider, or a lactation specialist if you have any concerns regarding breastfeeding or pumping and storing breast milk.