Breast-feeding techniques

Proper techniques are crucial for successful breast-feeding. Although some aspects of breast-feeding come naturally, learning new skills also is important. Before your baby is born, take classes, read books, and watch videos that demonstrate breast-feeding techniques. If you have concerns about your ability to breast-feed, talk to a lactation consultant while you are pregnant. After your baby is born, it is helpful to have one-on-one instruction with a lactation specialist or other knowledgeable health professional.

Basic breast-feeding techniques

• Get comfortable. Find a position that is comfortable for both you and your baby. For all positions, make sure the baby's head and chest are lined up straight and facing your breast. Have 2 or 3 pillows and a glass of water or juice nearby.
• Decide which breast to start with. Although it is best to offer your baby both breasts at each feeding, alternate which breast you start with. If the baby takes only one breast at a feeding, which is common in the first day or two, start the next feeding on the other breast. Try to offer both breasts at each feeding.
• Get the baby latched on properly. An improper latch is painful and frustrating. It causes some women to stop breast-feeding. A proper latch-on helps prevent problems such as sore nipples, blocked milk ducts, breast infections, and poor infant weight gain. Position your baby's chest against your chest with his or her head and body aligned straight. Skin-to-skin contact while breast-feeding, especially during the first few days, helps promote bonding with your baby.
  • Start by lightly touching the middle of your baby's lower lip with your nipple until the baby opens his or her mouth. The baby's mouth needs to be wide open, like a yawn, before attempting to latch.
  • With your fingers under your breast and your thumb resting on top of your breast (the "C hold"), bring the baby quickly onto the nipple and the areola (the dark circle around the nipple), so it goes deep into your baby's mouth. You may feel pain briefly when the baby latches on to the breast, especially in the first few days of breast-feeding. The pain should go away in less than a minute. If the pain does not go away after the first minute of breast-feeding, remove the baby from the breast and re-latch the baby. If that fails, try a different position.
  • As you are getting started, if the baby does not immediately get the idea to suck, squeeze a little milk into his or her mouth.
  • Look for signs that your baby is getting enough milk. Listen for a regular sucking and swallowing pattern while the baby is feeding. Dimpled cheeks and clicking or smacking noises may mean that the baby is sucking on his or her tongue instead of the nipple. Remove and reposition the baby. If you cannot see or hear a swallowing pattern, watch the baby's ears, which will wiggle slightly when the baby swallows.
  • If the baby's nose appears to be blocked by your breast, reposition him or her by raising the baby's hips or relaxing the baby's head back slightly, so just the edge of one nostril is clear for breathing. Do not press on your breast to clear the baby's nose, because this pulls on your nipple and may cause nipple soreness.
• Remove your baby from the breast. Any time you need to remove your baby from the breast, put one finger into the corner of his or her mouth and push your finger between your baby's gums to gently break the seal. If you do not break the tight seal before you remove the baby from your breast, your nipples can become sore, cracked, or bruised.
• Switch to the other breast. Offer the other breast when the first breast feels empty and the infant sucks more slowly, pulls off, or loses interest. Usually the baby will continue breast-feeding, though perhaps for less time than on the first breast. At first, the baby may breast-feed only 3 to 5 minutes on one breast. Later, feedings may last 10 to 25 minutes or longer on each breast. These rates vary, and you do not need to time each feeding. Let your baby feed until he or she is satisfied.
• Burp your baby. When your baby is satisfied, gently pat his or her back to help him or her let out any swallowed air. After the baby burps, offer the breast again. Sometimes a baby will want to continue feeding after being burped.

Keeping it calm and relaxed

Breast-feeding may go more smoothly in the first days and weeks if you and your baby are relaxed.

• Keep the room darkened. Bright light makes it difficult for newborns to open their eyes.
• Make sure the room is quiet and warm, and that you are able to relax. Eliminate or ignore distractions, such as the phone.
• Keep something to drink nearby. Most women get thirsty as they breast-feed. Drink enough to satisfy your thirst.
• After your baby latches onto your breast and is feeding well, try using a pillow or receiving blanket to maintain a comfortable position for both of you. Many women get sleepy while breast-feeding: having your baby fully supported while you doze allows you to get some needed rest.

Other important tips

• In the first few days, you may need to wake the baby to breast-feed every 2 to 3 hours.
• If your baby falls asleep before finishing breast-feeding, you may need to stimulate him or her to finish the feeding. (Newborns and babies with jaundice may be hard to keep awake.) Tickle the baby's feet or neck, keep the baby cooler by undressing him or her, change the baby's diaper between breasts, or use a cool damp washcloth on the baby's face. After a while, you will learn your baby's patterns and will know whether he or she needs rousing or has fed long enough.
• Avoid using artificial nipples such as bottles or pacifiers, at least until breast-feeding is well established (usually about 4 to 6 weeks). This also means other caregivers should wait to give a bottle to the baby. Feedings should be given only by the mother at the breast. The other caregivers can bond by holding, cuddling, changing clothes and diapers, and generally spending time with the baby.

Breast-feeding in public

To feed your baby on demand, it is inevitable that you will need to breast-feed in public on occasion. It may help to think ahead about strategies that would help make these feedings comfortable for you.

• In many states and on federal property, your right to breast-feed in public is protected by law.
• Look for a private or semiprivate area, such as a fitting room or a quiet corner in a lobby.
• Wear a loose-fitting blouse or a shirt that can be raised easily (a loose T-shirt or sweater works fine). If you are wearing a top with buttons, unbutton it from the bottom up and leave the top buttons closed. You can wear a top that is specially designed for breast-feeding, but it is not necessary.
• For added privacy, lay a lightweight blanket over your shoulder and chest to cover your breasts and the baby.