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Precious Moments

Making the Most of First Nursings
By Melissa Clark Vickers, IBCLC

You've done your "homework" and are as prepared as anybody can be for such a unique experience. And hopefully, you've decided to breastfeed your baby. There's time for one more breastfeeding lesson before you begin: the first nursings.

When is the best time to put my newborn to my breast?
Most babies are eager to learn within the first hour or so after birth. They are usually wide awake and alert. This is a perfect time to cuddle and offer the breast. The full-term baby is born with energy reserves that tide him over for a while, so this first nursing is more of an introduction than a real feeding. That takes a lot of pressure off you.

Some babies are sleepy – especially if you have had a lot of medication during your labor and delivery. Even if he's not awake enough for a real breastfeeding, you both will benefit from this cuddle session. There will be plenty of time to learn later on. And even if you and your baby are separated right after birth for whatever reason, you can still make up for lost time.

How do I nurse Baby the first time?
The key to successful breastfeeding is how you position the baby. It is normal to feel awkward at first, but soon you'll both be pros. First of all, you need to be comfortable, so use pillows behind you and under your arms to support yourself and your baby.

Next, think about how you will place your baby at the breast. Your breast is his dinner plate. It needs to be right in front of him, with your nipple at his mouth level. He shouldn't have to turn his head side to side or front to back to reach the nipple. You may need to place a pillow under him to raise him up a bit. Turn him on his side, facing you. This is especially important and is one big difference between breastfeeding and bottle-feeding. His tummy should be next to you, and with a tiny newborn, it may actually lie across your other breast. His hip, shoulder and ear should be in a straight line, and one hand should be on either side of your breast.

Cradle your baby in your arm with his head near the bend of your elbow, and his bottom in that hand. Use your other hand to support your breast. Place your thumb on top and cup your fingers underneath, holding the breast well away from the nipple and areola (the dark area around the breast). Tickle your baby's lips with your nipple and wait for him to open WIDE, like he's yawning. Be patient! Anything less than a wide opening can result in him latching on to your nipple rather than the breast – and that hurts!

When he does open wide and his tongue is down, hug him quickly to your breast.

What will it feel like?
I remember being surprised at the strength my babies had that first time. Tiny as they are, newborns are ready, willing and able to nurse! You'll feel some suction, but it shouldn't hurt! If it doesn't feel right, then use your little finger to slide in the corner of his mouth. This will break the suction, and you can gently take him off and try again. Remember, this is practice!

Will he get any milk?
This is a common concern of new moms, and naturally so. Remember that pregnancy has been preparing your body to breastfeed, and delivery sets full milk production in motion. You already have colostrum – the concentrated "liquid gold" – and your mature milk will come in a few days from now.

Take a look at your baby's fist. That's how big his stomach is! It won't take much to fill him up, and he may be ready to eat again soon. That's the wonderful thing about how the whole system works. Both of you need to practice to get comfortable nursing, and his body is set up to need small amounts of milk at a time. Your colostrum is just perfect for short, frequent feedings. By the time your mature milk comes in, you'll both be ready.

How can I tell if my baby is latched on well?
There are a number of good signs:

  • It doesn't hurt! This is so important. If it hurts, then something is not quite right. A minor change in positioning can make all the difference in the world in comfort at the breast.
  • He is breast-feeding, not nipple-feeding. He should have about an inch of the areola in his mouth so that his jaw and tongue action are milking the sinuses, or storage areas, not just clamping down on the nipple. Think of your breast as Grand Central Station. Various train tracks (milk ducts) are coming from all around the breast. They deliver the passengers (milk) to a central waiting area (sinuses) and wait for the front doors (nipple) to open. Clamping down on the nipple is like locking those doors!
  • His lips look like fish lips, both curled outward.
  • His tongue is cupped under your breast. You may be able to gently pull back on the corner of his mouth to see the tongue.
  • His jaw movements are rhythmical. His cheek muscles will be working (but not sinking in), and he may even wiggle his ears! Listen for a soft "kaw-kaw" sound that means he's swallowing.

In time, all this will be second nature to you. Just as learning any new skill requires practice, the more often you put your baby to your breast, the quicker both of you will learn. And remember, if you need help, just ask.

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About the Author: Melissa Clark Vickers, MEd, IBCLC, is an International Board Certified Lactation Consultant (IBCLC) and an iParenting expert panelist.

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