Getting started with breastfeeding

This page helps you getting started with breastfeeding so your baby and you have an awesome start into life and healthy development.

Benefits of breastfeeding

The American Academy of Pediatrics (AAP), Center for Disease Control (CDC), and World Health Organization (WHO) all agree that breastfed babies have improved neurodevelopmental outcomes and a reduced risk for a variety of diseases like asthma, diabetes, ear infections, respiratory infections, diarrhea … and more! Breastfeeding also benefits mom: it reduces the risk of type 2 diabetes, breast and ovarian cancer, and high blood pressure.

How long to breastfeed

The American Academy of Pediatrics (AAP) and World Health Organization (WHO) recommend

• early initiation of breastfeeding within 1 hour of birth;
• exclusively breastfeeding for the first six months of life; and
• introduction of nutritionally-adequate and safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond.

Establish your breastmilk supply

For your milk to come in after giving birth, it is important to signal your body early on that it needs to start producing milk. There are two ways to do that: baby nursing on your breast and hand-expressing. At the beginning, your body will start making colostrum, a thick yellow-ish liquid containing lots of anti-bodies and nutrients to your baby. Once your milk comes in, you will notice the color of your milk change to white, and the consistency will be more of a fluid liquid compared to colostrum. In the first few days, you can follow up each breastfeeding session with manual expression to stimulate your breasts to make more milk. Especially if your baby needs supplementation with formula for a few days until your supply increases, it is important to keep stimulating your milk production. You should stimulate your breast to make milk at least eight times in 24 hours, as often as if you were breastfeeding.

Hand-express colostrum and milk

If your baby cannot breastfeed soon after birth or has problems latching on, you should start hand-expressing colostrum as soon as possible until your milk comes in. You can feed the colostrum to your baby either on your finger or with a spoon or syringe, which your nurse or midwife will be happy to provide you while at the hospital. You should express colostrum eight times in 24 hours, as often as if you were breastfeeding. That way you stimulate your breasts enough so your milk comes in. Once your milk comes in and the quantity of expressions increase, you can collect the expressed milk in a small cup and feed it to baby through a feeding syringe.

Demand feed at least every 3-4 hours

In the first few weeks, your baby should be fed on demand whenever your baby gives you cues about being hungry, and at least eight times in 24 hours. If your baby doesn’t wake up every three to four hours, you should wake your baby up to feed. The time between feedings is calculated from the beginning of one feeding to beginning of the next feeding (not end of one to the beginning of the next). Newborns are not capable of sleeping through the night and it is risky if they actually sleep longer than three to four hours at a time.

Feeding cues

Your baby will show cues about being hungry. Some cues show up early, some late:

• Early cues signal “I’m hungry.” They include stirring, opening the mouth and turning the head seeking/rooting. Babies feed best at this time.
• Mid cues signal “I’m really hungry.” These include stretching, increasing movement and hand to mouth.
• Late cues signal “Calm me, then feed me.” They include crying, lots of movement and the color turning red.

Breastfeed LA has a nice poster to visualize the hunger cues – we recommend printing it and taking it with you to the hospital.

Positions to breastfeed

There are a number of positions you can use to breastfeed your baby. You should try them out and see which one works best for you and your baby:

• Laid-back breastfeeding. Mom leans back and is supported with pillows, baby is tummy-to-tummy on her. This is the most natural position for a baby to feed, so unless you’ve had a C-section this could be a good start.
• Side-lying hold. Mom and baby are both laying on the side facing each other. If mom is on her right side, baby feeds on the right breast. This position is good after a C-section since there is no pressure on the abdomen.
• Football hold. Mom holds baby with her arm on her side, with the baby’s head being in her hand. If baby is on the right side, Mom nurses on the right breast. This position is also good after a C-section.
• Cross-cradle hold. Mom holds baby with her arm in front of her, with the baby’s head being in her hand. If baby is on the right arm, Mom nurses on the left breast. Mom’s other hand can hold the breast to help baby.
• Cradle hold. Mom holds baby with her arm in front of her, with baby’s head where her elbow is. In this position, make sure baby’s head is not turned to reach the breast. This position works better once feeding is established.

Burp baby after every feeding

Your baby will very likely swallow some air during feeding – irrespectively if your baby feeds from the breast or a bottle. Burping helps your baby release that trapped air, and hence avoids spit ups and discomfort. There are generally three positions to burp your baby – try which is most comfortable for you and baby, and if you don’t get a burp after two or three minutes, try changing up positions:

• Over your shoulder. Sit up straight or stand, and hold baby on one side of your chest so that baby’s chin rests on your shoulder. Hold baby with one arm and gently pat or rub baby’ back with the other hand. Make sure baby can breathe well, and baby’s head isn’t too far up or down – especially in the beginning when baby can’t hold the head up yet. A mirror or your partner can help you check.
• Sitting on your lap. Sit up straight and sit your baby on your lap facing away from you. Your hand should support baby’s chest and your fingers hold up baby’s chin. Then pat or rub baby’s back with your other hand.
• Laying on your lap. Sit up straight and lay your baby on your laps perpendicular to you. Your hand should support baby’s chin, and make sure the head isn’t lower than the rest of baby’s body to avoid a blood rushing to the head. Pat or rub baby’s back with your other hand.

Get help from an IBCLC lactation consultant

Don’t be shy to ask for help. Some new moms struggle getting their newborn to latch on properly even after attending a breastfeeding class. Many hospitals have lactation consultants on staff to help you establish breastfeeding after birth while you’re still in the hospital during the first few days postpartum. The International Board of Lactation Consultant Examiners (IBLCE) certifies health professionals specializing in lactation consulting as IBCLCs. You can find an IBCLC locally in your area here.

Lactation consulting should be covered by your health insurance due to the Patient Protection and Affordable Care Act (“Obamacare”), but check with your insurance prior to giving birth since they may have limitations and may not cover all lactation consultants in your area as “in network”. It is best to find a lactation consultant prior to giving birth, so that you have their number ready in case you need one postpartum.

Supplement with Vitamin D

While breastmilk contains almost all nutrients required for baby, the AAP found it lacks sufficient levels of vitamin D. To make sure baby gets enough vitamin D to develop absorb calcium for proper bone growth, the AAP recommends supplementing exclusive breastfed babies with a daily oral dose of 400 IU vitamin D beginning in the first few days postpartum until 12 months of age, and supplementing 600 IU vitamin D from 12 to 24 months.

Breastfeeding essentials

Nursing pillow

You spend 2 hours each day (based on 8 feedings 15 minutes each) feeding your baby. A nursing pillow makes this time more comfortable for your back by lifting up baby from your legs so you sit straight.

Nipple cream

Nipple cream soothes sore nipples and prevents them from cracking open after feeding or pumping. This one is organic, lanolin-free, unscented and you don’t have to wash it off before the next feeding.

Vitamin D drops

The AAP recommends supplementing breastfed babies with 400 IU vitamin D each feeding. These drops are convenient because addine you just one drop to your nipple or to a bottle is enough.

Nursing bra

Nursing bras open by the straps to expose your breast for feeding. It’s essential for feeding so you don’t have to take your bra off completely. This one is 90% cotton for extra comfort.

Nursing pads

Your breasts will likely leak at some point. Nursing pads help save your clothes and possibly prevent an embarrassing moment in front of colleagues or friends.

Nursing cover

A nursing cover provides you extra privacy while breastfeeding. It can also be used to throw over your car seat or stroller to protect baby from the sun or bright lights.

Burp cloths

You’ll need a few burp clothes – not just for burping your baby but for wiping drool and cleaning spit ups. You’ll want at least 2-3 burp clothes to ensure you always have a clean one.

Bibs

Bibs are great to catch any breastmilk or formula that runs down baby’s mouth, or to catch drool when baby gets a little bit older. Some are round shaped, others mimic a bandana like this one.

Baby formula (just in case)

It is good to have some baby formula ready for when you first start feeding and wait for your milk to come in, or if your baby has trouble latching on. It could save your baby’s life as this mother will tell you.

Read next:

Breast milk pumping tips

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