• Posted March 1, 2024

Breastfeeding 101: Tips for New Moms

There's a host of studies supporting the numerous ways breastfeeding helps baby's development -- and the health of mothers, too. 

However, too many women are hesitant to start breastfeeding or stick with it if they do, according to Nadine Rosenblum, a perinatal lactation program coordinator at Johns Hopkins Hospital in Baltimore.

"There are still so many misconceptions about breastfeeding and a general lack of support that many women discontinue breastfeeding or add formula when they don't necessarily need to,"she added.

First off, why breastfeed? 

There's an easy answer: "Babies who are fed only breast milk for their first six months of life are the healthiest,"Rosenbaum said. 

In fact, newborns are primed by nature and their own immune systems to receive breast milk, she noted. 

"It's what a baby's body expects to eat, consume and utilize most effectively,"according to Rosenblum.

Evolution has helped breast milk develop into the perfect nutrient source, and it contains hundreds of known nutrient types (with more yet to be discovered). 

There's something in breast milk to fit an infant's needs at every stage of development, and it's crucial to helping build up the immune system.

Studies have shown that breastfed babies are more resistant than formula-fed babies to developing asthma, allergies, eczema, respiratory illnesses, diarrhea, Crohn's disease, colitis, diabetes (both types), obesity and even childhood leukemias. It also seems to be protective against sudden infant death syndrome (SIDS).

Breast milk even changes by the weather: As outside temperatures rise, the water content of breast milk increases so baby stays hydrated, the Johns Hopkins expert noted.  

Formula just can't compete: "You can't manufacture what mom makes new for baby every day,"Rosenbaum said.

Breastfeeding helps mom's health, too

According to Rosenblum and experts at Johns Hopkins, breastfeeding a baby soon after birth boosts maternal health over the short- and long-term. 

For example, soon after delivery, commencing nursing helps a new mother expel the placenta, slows postpartum bleeding, causes the uterus to shrink to pre-pregnancy size and burns calories.

Over the longer term, women who breastfeed their children appear to have lower risks for osteoporosis, diabetes, breast cancer, ovarian cancer and endometrial cancer, along with heart disease and high blood pressure.

Getting started, 'latching on'

According to experts at the Children's Hospital of Philadelphia (CHOP), it can be intimidating for new moms to contemplate breastfeeding. After all, new babies typically nurse eight times every 24 hours.

Key to successful breastfeeding is what's known as the "latch-on,"the CHOP experts said. That's when baby latches his or her mouth to the nipple. 

"The key to successful breastfeeding is the way you position and latch your baby onto the breast,"the CHOP experts said. "You should hold the baby "tummy to tummy"so that there is no space between your body and your baby. The baby needs to be facing the breast."

Resist the urge to press onto the back the baby's head, but do support your breast with your hand during the feeding.  Keep your fingers way back behind the areola and be sure not to press inward on your breast (this will also help prevent sore nipples).

For the most successfully latch-on, "your baby needs to open his mouth wide enough to take both the nipple and some of the areola [the dark area around the nipple] into his mouth,"according to CHOP. "The corners of the baby's mouth should be at a wide angle and both his upper and lower lips should be outside his mouth."

There are some signs that a "latch-on"isn't working: 

• Sore nipples throughout the feeding, or cracked or bleeding nipples

• Nipples are creased or slanted once baby releases them

• Sucking or clicking sounds when baby is feeding

• Baby releases the breast after only a few sucks

• Baby's cheeks are dimpling as they suck

• Baby still appears hungry after nursing

• Baby has less than 6 to 8 wet diapers per day

Do I have enough milk for my baby?

Worries about milk insufficiency are common among new moms, the CHOP experts said. Especially during the first week of life, babies may breastfeed more often, and moms might interpret this to means that they lack sufficient milk. 

But that's a normal stage of the breastfeeding process, the experts said. In fact, nature has designed breastfeeding so that the milk supply increases with a baby's increasing demand. Your breasts should feel softer after a feeding, and that's a good sign that baby is getting enough milk.

Resist the temptation to "supplement"breastfeeding with formula or bottle-feeding, the CHOP experts said. 

"Bottles cause problems in two ways. They fill your baby up, so he won't breastfeed as often. When you breastfeed less often, you will not make as much milk,"the CHOP experts wrote.

"Bottle-feeding also causes problems with sucking at the breast,"they added. "The bottle nipple is shaped much differently from your nipple and milk flows faster from the bottle. Babies may become confused when bottles or pacifiers are offered in the early weeks when they are just learning how to breastfeed.

Babies are getting enough breast milk when they:

• Breastfeed at least 8 times per every 24 hours, usually in a rhythmic suck/swallow/pause/suck pattern.

• Don't display "feeding cues"(rooting, sucking on fingers) after a feed

• Have one wet diaper on day 1 of life and three on days 2 and 3. By day 6 they should have six to eight wet diapers per day

• Have "soft, yellow, seedy stools by day 5."If baby doesn't pass stools by this time, call your pediatrician, the CHOP experts said.

• Are gaining weight. "Breastfed babies should stop losing weight around day 4-5 when your milk comes in,"the CHOP team said. "They usually return to birth weight by 2 weeks of age. Normal weight gain after the second week is about 1 ounce per day."

How long should each breastfeeding session last? 

As a rule of thumb, allow your baby to breastfeed for at least 15 minutes.  The CHOP experts note that breast milk is more watery at the beginning of a nursing session, and gets fattier as breastfeeding continues, until baby is receiving high-fat "hind"milk towards the end of a feeding. This highly nutritious form of breast milk is important, so allow baby sufficient time to receive it. 

Babies typically let you know when they are full by releasing the breast. At that point you can burp baby or change their diaper. You may want to offer them the second breast. If baby is hungry they'll accept the breast and suck.

"Make sure to alternate the side you start with because the baby's suck is always stronger at the beginning of the feeding,"the CHOP experts said. 

Growth spurts

New mothers will notice that, at around 2 weeks, 6 weeks and 3 months of age, infants may want to breastfeed every 1 to 1½ hours for a day or two. That's because they are typically undergoing growth spurts at these ages. 

Baby's demand triggers an increase in mom's milk supply. " Allow your baby to breastfeed as often as he wants during these days and you will make enough milk in a day or two,"the CHOP experts said.

When to call your pediatrician

There are signs that breastfeeding is less than optimal, and you may want to reach out to your pediatrician. These signs include:

• You believe baby isn't getting enough milk

• There's a white coating on your infant's tongue and cheek that doesn't come off

• Baby seems jaundiced, with a yellowish tinge to their eyes or skin

• You develop flu-like symptoms, breast pain and/or fever.

Breastfeeding support

According to Johns Hopkins' Roseblum, there's plenty of reliable support out there to help moms through the breastfeeding process. 

Joining a prenatal breastfeeding class can be a great help, she said. "These classes cover the benefits of breastfeeding, basics of milk supply, how to maintain milk when mom and baby are apart, how to understand baby behavior and gauge when a baby is well-fed, and positions for a good latch,"  Rosenbaum said.

Once you are breastfeeding, it's best to forgo random internet searches on the subject and talk directly with a lactation expert, she said. "Lactation experts can direct women to good information and provide hands-on help at the hospital. If women aren't able to meet at the hospital, nurses are also available to answer questions over the phone or by email,"she said.

Find a local support group. Many hospitals help coordinate support groups for breastfeeding women. At these gatherings, "mothers can share stories, learn from each other's experiences and practice breastfeeding in a group setting,"Rosenbaum explained.

SOURCE: Johns Hopkins Hospital, Baltimore; Children's Hospital of Philadelphia