Breastfeeding and Baby Confidence

The National Childbirth Trust (NCT), La Leche League and The Breastfeeding Network are all organisations that provide support if you are experiencing problems when you first arrive home with your newborn.

Breastfeeding comes naturally to some mothers, while others experience breastfeeding problems. These can occur because your baby is very sleepy, has an undiagnosed tongue-tie or if there is a problem with the latching process. Help is available and any mother experiencing problems needs to address those problems as soon as possible to enable her to feed in a relaxed and confident manner.

Learning as much as possible during pregnancy about breastfeeding is most helpful - see end of this section for a list of suggested reference books and other helpful websites.

Whether you intend breastfeeding or bottle-feeding your baby, be prepared for broken nights and muddled days where nothing seems to go according to plan. Confusing as this may sound, it is the norm and will not last indefinitely.

Establishing breastfeeding

In the first few days after birth, increase the nursing time to satisfy your baby's hunger when this becomes necessary. As soon after the birth as you are able, put your baby to the breast. Baby may latch on with very little assistance. Whatever happens at this first attempt, remain relaxed. If your baby latches on straightaway and you are comfortable, let him suckle for several minutes, but try to avoid long periods of prolonged sucking as this could cause nipple discomfort. There will usually be a midwife, your partner or a health professional with you to assist. Do not be afraid to ask for help or advice if you are confused or experiencing problems!

Once you have recovered, and are rested and feeling strong enough to attend to your baby without assistance, encourage him to suckle whenever he wakes and seems hungry. Initially you will feed on demand. This is the best way to establish your milk supply and helps prevent engorgement.

A healthy newborn baby is very happy to suckle and demand feed – taking enough colostrum in the first few days of life while learning to latch on successfully for when the milk comes in, approximately three or four days after birth. Only colostrum is produced by the breast in the first few days and when the milk does come in your breasts will increase in size and feel heavier than normal. You could also experience some engorgement when the breasts become tight, hard and lumpy.

Continue feeding your baby little and often during the day, and after a last feed at approximately 11pm, it is acceptable to leave your baby to wake of his own accord unless you have been advised otherwise by your health professional.

To avoid too much trauma to sensitive nipples, a first-time mother can limit the suckling to 5-10 minutes on each breast in the first day or two. Newborns tire easily, so offer the breast every three hours, unless your baby wakes sooner than this in the first day or two. Increase the nursing time to satisfy your baby's hunger, until your baby requires his next feed.

Demand-feeding a newborn keeps your milk supply boosted, but breastfeeding can be compatible with working towards a routine that works for you and your family. If a baby is latching on and sucking well, and there are no other feeding problems, after three or four days you can encourage your baby to take a good feed each time in the hope that he will be satisfied enough to sleep for three hours before waking for another feed.

If you want to establish some sort of routine within the first two to four weeks, wake your baby from sleep every three hours during the day (daylight hours for a newborn tend to be 6am-11pm), unless the baby wakes naturally on his own for a feed. Change his nappy, chat to him calmly and offer him the breast. Feed him on one side for up to 20-35 minutes, then wind him well, holding him firmly upright. If he needs changing again, change his nappy and offer the other breast, feeding for as long as your baby is sucking. If he dozes off to sleep, gently insert your little finger into his mouth and take him off your breast. Hold him upright and wind him. Once winded and relaxed, your baby should be ready to sleep for another two hours.

Winding your baby when he falls asleep during a feed is a good way of waking him up, as is laying him down flat after winding, changing his nappy or changing his clothes.

How long it takes to feed a newborn baby

A full breastfeed takes about an hour in the early weeks – with on average 30-45 minutes spent on actual feeding and the rest of the hour spent winding, changing and waking up. Newborns tire easily at first when nursing at the breast and the actual length of time for each baby varies as it depends largely on his sucking technique and your let-down reflex (i.e. the speed at which the milk is delivered to him as he suckles). Being relaxed, and not distracted, whether breast- or bottle-feeding, is the ideal state of mind for bonding with your baby.

During a feed, if your baby is not sucking and appears to be asleep (in a milk stupor) encourage him to wake up and finish the feed. A baby cannot let you know he’s full if he is asleep. Always try to give your baby a good feed, where your baby feeds well at each breast for 15-20 minutes, perhaps up to 35 minutes or more on some occasions.

To remove a sleepy baby from your breast, insert your finger in the corner of his mouth to break the suction. Never pull your baby off your breast as this can cause damage to your nipple which could result in you developing mastitis.

What is a ‘good feed’? A newborn baby with a full tummy, hunger satisfied, will sleep for two to three hours before needing to be feed again. If your baby wakes earlier than this and is genuinely hungry, always feed him as he is too young to be expected to wait. You can make this a shorter feed and then he should feed well at the following feed. Babies are like us, they do not always consume as much at one feed as they do at the next. It is the amount of milk that your baby consumes over 24 hours, not how much breast milk he takes at each feed that satisfies his appetite and nourishes him.

Every baby is unique and different, and what works for one baby may not work for another when it comes to breastfeeding. It is advisable to find a book that will satisfy your curiosity and answers any queries you have. Studying in advance of the birth of your baby and building up some knowledge of this womanly practice will help you to manage on those days when everything seems to go haywire. We all have those days, even the most experienced of mothers.

Hungry cry: usually starts two and a half to three hours after the last feed. Over the following weeks this will extend gradually to waking every three to four hours after the beginning of the last breastfeed, because your baby will be able to consume more milk at each feed as his body and tummy grows.

Cluster feeding: during growth spurts and days when your baby seems to be more hungry, you may find your baby requires extra feeds. This can happen at any time during the day or night, but normally happens in the evening. Babies who cluster feed can nurse on and off for 2-3 hours at a time.

If solely bottle-feeding, count the time from the end of the last feed, as formula takes longer to pass through the stomach lining than breast milk. You will find all the instructions on how often and how much on the back of the formula container.

Settle yourself comfortably in a chair or settee with a straight back. Sit upright and support yourself with cushions if necessary. Hold your baby in the cradle position and raise him up with a pillow or cushion, if required. Baby needs to open his mouth wide to take in a large amount of breast tissue and most of the areola, the darker pigment which surrounds the nipple.

Latching on should not hurt. If you are uncomfortable, insert a clean little finger into the side of your baby’s mouth to release the suction and try again.

Breast milk

Breast milk is a complete food. It has 400 natural nutrients as well as hormones and disease-fighting compounds. Babies that are exclusively breastfed from birth are less likely to become ill in their first year of life. Research has found that being exclusively breastfed for six months can improve a baby’s cognitive development and provide a huge benefit to their immune system.

Breast milk is produced on a supply and demand basis, which means most breasts produce adequate milk for each individual baby’s demands. The more your baby demands to be fed, the more milk the breast will produce.

Problems that could occur whilst breastfeeding

Unfortunately, there are some girls who, no matter how conscientious and careful they are, develop sore nipples. This is sometimes due to the fact that they have very fair and delicate skin. In my capacity as a maternity nurse I have known two girls who suffered considerable discomfort in the first few weeks of breastfeeding and although they applied their cream and their babies were latching successfully, in the end they needed to use nipple shields. Initially at every other feed and occasionally for short periods of time when their nipples became too tender to feed without them. These, however, were exceptional cases and although nipple shields are available, they are not recommended for use indefinitely.

If you do experience sore nipples from being engorged or because your nipples become cracked and sore, it is preferable to seek advice from an experienced midwife, breastfeeding counsellor or health visitor.

Primary engorgement is when your breast fills up with milk and becomes over-full. This condition usually only occurs when the milk comes in faster than your baby can empty the breast by feeding. This results in a situation where it is sometimes very difficult for your baby to latch on.

Every mother’s experience and situation will be different, therefore if you plan to breastfeed it is essential to have some knowledge of what to expect before the birth.

If you are following a routine and it’s not going to plan, do not stress about it and do not get upset. Just keep trying and relax.

Recommended books and websites to read

If you do not fancy reading a book, an interesting DVD you can watch is Breastfeeding without Tears by Clare Byam-Cook.

Watch this beautiful clip, which shows how babies instinctively crawl up their mothers’ stomachs towards the nipple after birth. The clip is also informative for mothers who plan to breastfeed.

Key Points To Take Away

  • Always seek support if you are having problems
  • Read up on breastfeeding during and after pregnancy
  • You will more than likely experience broken nights but these do not last indefinitely
  • Soon after the birth of your baby, offer your baby your breast, relax and try to avoid prolonged sucking
  • Feeding on-demand initially helps establish your milk supply and helps to avoid engorgement
  • If you want to establish a routine, you can try to find a routine that works for you after four to six weeks, if your baby is latching on correctly without any problems and your milk supply is stable. Try to encourage baby to have full feeds then sleep for two to three hours
  • If you want to establish a routine, wake baby up every three hours from the beginning of the last feed during daylight hours. Feed them for 20-35 minutes on one breast, wind them, change nappy if required. Try your baby on the other breast until he is satisfied and then wind the baby again and settle your baby to sleep
  • Always wind your baby during and after each feed
  • Try to wake your baby up if they fall asleep during a feed
  • If formula-feeding, follow the instructions on the packet
  • Common problems which may occur are sore nipples or engorgement