A Guide to Breastfeeding
A UT Health Austin obstetrician-gynecologist provides breastfeeding guidance to new and expectant parents
Reviewed by: Denise Johnson, MD
Written by: Kaylee Fang
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, so reach out for help early and often.”
What can I expect when getting started?
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. 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 breast may begin to feel full, firm, and warm. As time progresses, there will be an increasing amount of liquid allowing routine breastfeeding to occur.
Breastfeeding has the combination of nutrition and antibodies to help the baby grow. For example, colostrum includes nutrients to support your baby’s immune systems as they begin to develop. The risk of common infections, such as in the ear, can be reduced when the body contains these antibodies. Therefore, your baby’s health improves going forward where it can even lower the risk of obesity and diabetes.
Breastfeeding supports a bond between you and the baby. Another benefit is improved weight loss after pregnancy. Breastfeeding can lower the risk of diabetes, high blood pressure, breast cancer, and ovarian cancer.
There are various positions to try as you begin to explore what’s ideal for you and the baby. As each baby’s body is different, there are different holds that fit best. Most common positions are:
- 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 to have the head aligned with the front of your body. You can change positions throughout different feeding times as long as you and the baby are comfortable and breastfeeding successfully.
How often should I breastfeed?
In the first few weeks, up to 8 to 12 times a day. At times, you’ll go through a phase where the baby is cluster feeding for up to 30 minutes.
How long should I keep breastfeeding?
Every decision is based on what you believe is best for you and your baby, so there’s no requirement. 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 the first year of breastfeeding. The time to stop breastfeeding is a personal choice for you and your baby.
Care for breasts
Maintain routine hygiene just as you would for the rest of your body.
- Wash your hands before touching your breasts
- Don’t let your breast get too damp or dry
- Change your nipple pads frequently
- Wear a supportive bra that’s not restrictive
Addressing Common Concerns
A common reason why many will stop breastfeeding is because they experience pain and discomfort. A bit of soreness is natural while getting adjusted to breastfeeding. Pain can be reduced by ensuring a proper latch where the baby’s whole mouth is over the nipple, and not just at the tip. You should seek immediate help if there is ongoing pain and swelling, such as cracking in 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. Your provider, lactation consultants, or postpartum doulas are available to help troubleshoot comfortable positions and proper latch for you and baby,” recommends Dr. Johnson.
All breast sizes and shapes can effectively feed the baby.
“We work to find the proper position and latch for different shapes and sizes. You can still breastfeed with inverted nipples in particular. Sometimes we recommend a nipple shield to help baby form the proper latch for breastfeeding,” explains Dr. Johnson.
Lack of Milk Supply
Attempting to breastfeed at least 8 to 12 times a day can feel overwhelming at first, especially when you’re experiencing low milk supply. If the baby is growing appropriately and making enough wet diapers, there may be enough milk supply.
“If you feel like it’s low, then you can work with your provider to make sure that you’re not taking any medications that are interfering with milk supply. They can work with you to suggest other supplements or medications to support more supply,” advises Dr. Johnson
Oversupply of Milk
Another challenge that many experience is oversupply of milk, which is the cause of engorgement. Breasts are super full and can be painful at the time. You can consider putting warm compresses before you feed or cold compresses after you feed.
“We recommend [that people who breastfeed] continue their prenatal vitamin that often has all the necessary nutrients. In addition, make sure that overall, you’re taking care of Mom and that they are taking care of themselves. Making time to eat and hydrate appropriately is the best thing you can do to support good breastfeeding,” suggests Dr. Johnson.
Learn the basics beforehand. Just like learning any new skill, you can start reading and consider taking birth or breastfeeding classes before the baby arrives.
Form a support team. Identifying a team in advance can prevent many challenges associated with breastfeeding. Focusing on the latch and position are the foundation of breastfeeding, so that would be a key to success when working with your team. Don’t be afraid to ask questions early and often.
Support Mom. Protect Mom’s time and space to focus on breastfeeding. One way to accomplish this is to manage visitors and take care of other children, if there are any, in the house.
Take on housework. Take care of any chores and help care for the baby between feedings. When the baby has finished eating, hold and burp them. Changing diapers and being supportive in these ways can go a long way.
“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.
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