A Guide to Breastfeeding
UT Health Austin obstetrician-gynecologist provides breastfeeding guidance to new and expectant parents
Reviewed by: Denise Johnson, MD
Written by: Kaylee Fang
Breastfeeding is a remarkable journey that nurtures both the physical and emotional well-being of both mothers and their newborns. It’s a natural process that provides infants with vital nutrients while fostering an unbreakable bond between mother and child. However, like any journey, breastfeeding comes with its unique set of challenges and questions.
“Parents with questions about breastfeeding should not be afraid to reach out for help,” says Denise Johnson, MD, an obstetrician-gynecologist in Women’s Health, a clinical partnership between Ascension Seton and UT Health Austin. “While breastfeeding is a natural process, it’s not always an easy or smooth process. You are not expected to automatically know what to do, and reaching out for help early on and often can make all the difference.”
After delivery, breasts will produce a thick yellow substance known as colostrum. Colostrum usually provides babies all the nutrition they require during the first few days after birth. Your baby’s sucking will signal the body to start producing a thinner white substance known as milk. Milk typically appears 3 days following delivery, and your breasts may begin to feel full, firm, and warm. As time progresses, there will be an increasing amount of liquid, allowing routine breastfeeding to occur.
Ideal Holding Positions
There are various positions you can try as you begin to explore what’s ideal for you and your baby. Just as each baby’s body is different, there will be different holds that work best.
Most common holding positions include:
- Cradle hold: baby’s head is tucked into the bend of your elbow
- Football hold: baby’s body is off to the side
With any of these positions, it’s important that the head aligned with the front of your body. You can change positions throughout different feedings as long as you and your baby are comfortable and the feeding is successful.
Frequency and Duration
In the first few weeks, you will want to breastfeed your baby up to 8 to 12 times a day. At times, you may go through a phase where your baby is cluster feeding for up to 30 minutes.
Every decision is based on what you believe is best for you and your baby, so there’s no requirement on how long you should continue breastfeeding. The American Academy of Pediatrics defines exclusive breastfeeding as providing the baby’s key nutrients throughout the first six months of life. This exclusive breastfeeding can be combined with food as you continue after the first year of breastfeeding. The appropriate time to stop breastfeeding is a personal choice that should be made with the needs of you and your baby in mind.
Care for Breasts
In order to ensure the health and comfort of your breasts, it’s important to adopt regular hygiene habits. Maintain routine hygiene just as you would for the rest of your body.
Routine hygiene practices include:
- Wash your hands before touching your breasts
- Don’t let your breasts get too damp or dry
- Change your nipple pads frequently
- Wear a supportive bra that is not restrictive
Breastfeeding not only plays a pivotal role in promoting the overall health, well-being, and long-term development of the baby, but also offers a range of physical and emotional advantages for mothers, enhancing their postpartum experience and well-being.
Benefits of breastfeeding for the baby may include:
- Antibodies and immune support: Breast milk contains antibodies, enzymes, and white blood cells that help bolster the baby’s immune system, providing protection against infections, illnesses, and allergies.
- Brain development: Breast milk contains essential fatty acids, such as DHA, critical for cognitive development and the growth of the baby’s nervous system.
- Enhanced bonding: Skin-to-skin contact during breastfeeding promotes emotional bonding between the baby and the mother, fostering a strong sense of security and attachment
- Improved digestive health: Breast milk is easily digestible, reducing the likelihood of gastrointestinal discomfort, colic, and constipation.
- Lowered risk of chronic diseases: Breastfeeding has been associated with a decreased likelihood of chronic conditions such as type 1 and type 2 diabetes, asthma, and certain allergies.
- Optimal nutrition: Breast milk is a perfectly balanced source of nutrients, promoting healthy growth and development during the critical early stages of life.
- Oral development: Breastfeeding requires the baby to use their tongue and facial muscles, which contributes to proper oral development and reduces the risk of issues like malocclusion.
- Proper weight gain: Breastfed babies tend to gain weight more gradually, reducing the risk of childhood obesity and related health issues.
Benefits of breastfeeding for the mother may include:
- Bonding and emotional well-being: The skin-to-skin contact and hormonal interactions during breastfeeding promote emotional bonding between the mother and the baby, contributing to improved mental and emotional well-being.
- Maternal health: The act of breastfeeding stimulates the release of hormones that promote relaxation and reduce stress, contributing to overall improved mental health.
- Postpartum recovery: Breastfeeding triggers the release of oxytocin, which helps the uterus contract, reducing postpartum bleeding and aiding in the uterus’s return to its pre-pregnancy size.
- Reduced risk of health conditions: Breastfeeding is associated with a lowered risk of certain health conditions for mothers, including type 2 diabetes, breast cancer, and ovarian cancer.
- Reduced risk of postpartum depression: The hormones released during breastfeeding, including oxytocin, can contribute to reduced postpartum depression symptoms and increased feelings of maternal attachment.
- Weight loss: Breastfeeding burns extra calories, aiding in post-pregnancy weight loss and helping mothers gradually return to their pre-pregnancy weight.
Breastfeeding can also present a range of concerns the can sometimes leave mothers feeling uncertain when navigating this process. Whether you’re a first-time mother or have breastfed before, understanding and addressing these concerns can contribute to a more positive and fulfilling breastfeeding experience for both you and your baby.
Pain and Swelling
A bit of soreness is natural when adjusting to breastfeeding. Pain and discomfort can be reduced by ensuring a proper latch, where the baby’s entire mouth is over the nipple and not just at the tip. You should seek immediate help if there is ongoing pain, swelling, or cracking of the nipple.
“Reaching out to the team that you’ve created around you is the best kind of way to address pain or any discomfort,” recommends Dr. Johnson. “Your provider, lactation consultants, or postpartum doulas are available to help troubleshoot comfortable positions and proper latch for you and your baby.”
All breast shapes and sizes can effectively feed the baby.
“We work to find the proper position and latch for different shapes and sizes of breasts,” explains. Dr. Johnson. “You can even breastfeed with inverted nipples. Sometimes we recommend a nipple shield to help the baby form the proper latch for breastfeeding.”
Lack of Milk Supply
Attempting to breastfeed at least 8 to 12 times a day can feel overwhelming at first, especially if you’re experiencing low milk supply. If the baby is growing appropriately and making enough wet diapers, you may actually have enough milk supply.
“If you feel like your milk supply is low, work with your provider to identify any potential medications or other factors that may be interfering,” advises Dr. Johnson. “They can work with you to suggest other supplements or medications to support more supply.”
Oversupply of Milk
While having an ample milk supply is generally considered a positive aspect of breastfeeding, an oversupply, more than what the baby needs for nourishment, can result in engorgement and lead to discomfort.
“Breasts that are super full can be painful at the time,” shares Dr. Johnson. “Placing a warm compresses on your breasts before you feed or cold compresses after you feed can help.”
While breastfeeding provides essential nutrients to the baby, it can also lead to nutrient depletion in the mother’s body. Therefore, some mothers may benefit from specific supplements to maintain their own health and to support the quality of their breast milk.
“We recommend that you continue taking your prenatal vitamins while breastfeeding,” says Dr. Johnson. “It’s important that you find time to take care of yourself. Making sure you eat throughout the day and hydrate appropriately is the best way to support an optimal breastfeeding experience.”
As you embark on your breastfeeding journey, it’s important to remember that every mother and baby experience it uniquely. Creating a supportive environment and understanding the potential hurdles of breastfeeding can empower you to make informed decisions for both you and your baby’s well-being.
Tips for breastfeeding moms:
- Learn the basics: Consider taking birth or breastfeeding classes before your baby arrives.
- Seek professional guidance: Consult a lactation consultant or healthcare provider for guidance and support.
- Establish a comfortable nursing environment: Create a quiet, comfortable, and relaxing space for breastfeeding to reduce distractions and promote bonding.
- Ensure proper latch and positioning: Ensure your baby has a good latch to avoid nipple pain and encourage efficient milk transfer, and experiment with different breastfeeding positions to find the one that is most comfortable for both you and your baby.
- Stay hydrated and eat well: Maintain a healthy diet and stay well-hydrated to support your own health and milk production.
- Pump when needed: If you need to build a milk stash or return to work, consider pumping milk to maintain your supply and provide breast milk when you’re not available.
- Establish appropriate nipple care: Apply lanolin or a nipple cream to soothe sore nipples and prevent cracking and ensure proper breast hygiene to prevent infection.
- Join support groups: Connect with other breastfeeding moms through support groups or online communities to share experiences and advice.
- Ask for help: Remember to prioritize self-care by resting when you can and accepting help from others.
Tips for caregivers:
- Provide encouragement and praise: Offer words of encouragement and praise for the mother’s commitment to breastfeeding, which can also boost her confidence and motivation.
- Create a supportive environment: Help with household chores, assist with other children, prepare nutritious meals, and watch the baby to give the mother more time to rest and breastfeed.
- Encourage Rest: Encourage the mother to rest and take naps when the baby sleeps, as adequate rest is crucial for her well-being and milk production.
- Be Flexible: Understand that breastfeeding can be unpredictable, and schedules may revolve around the baby’s feeding needs.
- Offer Validation: If the mother encounters breastfeeding challenges, validate her feelings and encourage her to seek professional help or join support groups.
- Celebrate Milestones: Celebrate breastfeeding milestones, such as the baby’s growth, successful feedings, and the duration of breastfeeding, with the mother.
- Respect Her Choices: Respect the mother’s choices regarding breastfeeding, whether it’s exclusively breastfeeding, pumping, or supplementing with formula when necessary.
“New parents should give themselves time and grace to learn this new process. Lean on communities and online resources if they have questions. While we support exclusive breastfeeding, ultimately, it’s important for parents to make the choice of how they choose to feed and bond with their baby. This can be breastfeeding, formula feeding, or a combination of both,” explains Dr. Johnson.