Breastfeeding: Getting started

How to start breastfeeding

The first time you hold your newborn in the delivery room, put his lips to your breast. Your mature milk hasn't come in yet, but your breasts are producing a substance called colostrum that will help protect your baby from infection.

Try not to panic if your newborn seems to have trouble finding or staying on your nipple. Breastfeeding is an art that requires patience and lots of practice. No one will expect you to be an expert in the beginning, so don't hesitate to ask a nurse to show you what to do while you're in the hospital. (If you have a premature baby, you may not be able to nurse right away, but you should start pumping your milk. Your baby will receive this milk through a tube or a bottle until he's strong enough to nurse.)

Once you get started, remember that nursing shouldn't be painful. Pay attention to how your breasts feel when your baby latches on. His mouth should cover a big part of the areola below the nipple, and your nipple should be far back in your baby's mouth. If latch-on hurts, break the suction — by inserting your little finger between your baby's gums and your nipple — and try again. Once your baby latches on properly, he'll do the rest.

How often you should nurse

Frequently. The more you nurse, the more quickly your mature milk will come in and the more milk you'll produce. Nursing for ten to 15 minutes per breast eight to 12 times every 24 hours is pretty much on target. According to the latest guidelines from the American Academy of Pediatrics (AAP), you should nurse your newborn whenever he shows signs of hunger, such as increased alertness or activity, mouthing, or rooting around for your nipple. Crying is a late sign of hunger — in other words, ideally you should start feeding your baby before he starts crying.

During the first few days, you may have to gently wake your baby to begin nursing, and he may fall asleep again in mid-feeding. To make sure your baby's eating often enough, wake him up if it's been four hours since the last time he nursed. Once your baby becomes alert for longer periods, you can settle into a routine of feeding every one to three hours (less at night as he starts to sleep through).

How to get comfortable

Since feedings can take up to 40 minutes, pick a cozy spot for nursing. Hold your baby in a position that won't leave your arms and back sore. It works well to support the back of your baby's head with your hand, but the position you choose really depends on what's comfortable for you. If you're sitting, a nursing pillow can be a big help in supporting your baby. Don't feed until you and your baby are comfortable because you'll be sitting (or lying) in that position for a while.

What you should eat

A normal healthy diet is all you need while you're nursing. Experts used to recommend that nursing moms get an extra 400 to 500 calories a day, but new research shows that you don't need that calorie boost, says breastfeeding expert Kathleen Huggins, author of The Nursing Mother's Companion. You'll want to maintain a well-balanced diet for your own health, but you don't need to follow complicated dietary rules to successfully nurse your baby.

You may want to limit caffeine, and avoid chocolate, spicy foods, and other irritants that get into breast milk and can bother your baby. Be sure to drink lots of fluids — the oxytocin released by your body while you breastfeed will make you thirsty and help remind you to drink.

Remember that although breastfeeding is natural, it can be difficult in the first days of your baby's life. Take the time to get encouragement and advice from a lactation consultant or friends who have nursed — their support and tips will be invaluable.

Problems you may encounter

Although women have nursed their babies for centuries, breastfeeding doesn't always come easily. Many women face difficulties early on. Some of the most common problems you may encounter in the first six weeks include:

• Engorgement: an overfull breast
• Sore nipples
• Mastitis: a breast infection

Don't suffer in silence. Call a lactation consultant or your doctor (especially if you think you may have a breast infection) if your physical discomfort is getting in the way of nursing properly.

What you may be feeling

Some women adjust to breastfeeding easily, encountering no major physical or emotional hurdles. But many new moms find it hard to learn — so if you're feeling discouraged, you're not the only one.

It's normal to feel overwhelmed by your baby's constant demands in the beginning. If you feel like giving up (or just want professional advice), consider calling an international board-certified lactation consultant (IBCLC). These experts in the art of breastfeeding will watch you nurse your baby and make recommendations. You can also talk to your doctor or midwife about any health concerns that may be getting in the way of successful breastfeeding.