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Breastfeeding Breastfeeding Management Information

Breastfeeding - Starting Out Right

Breastfeeding is the natural and normal way of feeding infants and young children, and human milk is the milk made specifically for human infants. Starting out right helps to ensure breastfeeding is a pleasant experience for both you and your baby. Breastfeeding should be easy and trouble free for most mothers.

The vast majority of mothers are perfectly capable of breastfeeding their babies exclusively for about six months. In fact, most mothers should be able to produce more than enough milk. Unfortunately, outdated hospital policies and routines based on bottle feeding still predominate in too many health care institutions and make breastfeeding difficult, even impossible, for too many mothers and babies. Too frequently also, these mothers blame themselves. For breastfeeding to be well and properly established, getting off to the best start from the first days can make all the difference in the world. Of course, even with a terrible start, many mothers and babies manage. And yes, many mothers just put the baby to the breast and it works just fine.

The basis of breastfeeding is getting the baby to latch on well. A baby who latches on well gets milk well. A baby who latches on poorly has more difficulty getting milk, especially if the milk supply is not abundant. The milk supply is not abundant in the first days after birth; this is normal, as nature intended, but if the baby’s latch is not good, the baby has difficulty getting the milk. It is for this reason that so many mothers “don’t have enough colostrum”. The mothers almost always do have enough colostrum but the baby is not getting what is there. Babies don’t need much milk in the first few days, but they need some.

Even if the mother’s milk production is plentiful, trying to breastfeed a baby with a poor latch is similar to giving a baby a bottle with a nipple hole that is too small—the bottle is full of milk, but the baby will not get much or will get it very slowly—so the baby sucking at the breast may spend long periods on the breast or return to the breast frequently or not be happy at the breast, all of which may convince the mother she doesn’t have enough milk, which is most often not true.

When a baby is latching on poorly, he may also cause the mother nipple pain. And if, at the same time, he does not get milk well, he will usually stay on the breast for long periods, thus aggravating the pain. Too often the mothers are told the baby’s latch is perfect, but it’s easy to say that the baby is latched on well even if he isn’t. Mothers are also getting confusing and contradictory messages about breastfeeding from books, magazines, the internet, family and health professionals. Many health professionals actually have had very little training on how to prevent breastfeeding problems or how to treat them should they arise. Here are a few ways breastfeeding can be made easier:

Note: Mothers are often told that if the breastfeeding is painful, the latch is not good (usually true), so that the mother should take the baby off and latch him on again and again and again... This is not a good idea. Instead of delatching and relatching, fix the latch that you have as best you can by pushing the baby’s bottom into your body with your forearm. The baby’s head is tipped back so the nose is in ‘sniffing position’. If necessary, you might try gently pulling down the baby’s chin so he has more of the breast in his mouth. If that doesn’t help, do not take the baby off the breast and relatch him several times, because usually, the pain diminishes anyway. The latch can be fixed on the other side or at the next feeding. Taking the baby off the breast and latching him on again and again only multiplies the pain and the damage and the mother’s and baby’s frustration.

Under some circumstances, it may be impossible to start breastfeeding early. However, most “medical reasons” (maternal medication, for example) are not true reasons for stopping or delaying breastfeeding, and you are getting misinformation. See the information sheets Medication and Breastfeeding and also Illness and Breastfeeding. Get good help. Premature babies (see the information sheet Premature Baby and Breastfeeding) can start breastfeeding much, much earlier than 34 weeks of age that seems to be the rule in many health facilities. Studies are now quite definite that it is less stressful for a premature baby to breastfeed than to bottle feed. Unfortunately, too many health professionals dealing with premature babies do not seem to be aware of this (see the information sheet Premature Baby and Breastfeeding).

Not latching/Not breastfeeding? If for some reason baby is not taking the breast, then start expressing your colostrum by hand (often much more effective than using even a hospital grade pump) should be started within 6 hours or so after birth, or as soon as it becomes apparent baby will not be feeding at the breast. see the information sheet When the Baby Does Not Yet Latch On.

Written and revised (under other names) by Jack Newman, MD, FRCPC, 1995-2005
Revised Jack Newman MD, FRCPC, IBCLC and Edith Kernerman, IBCLC, 2008, 2009

This handout may be copied and distributed without further permission, on the condition that it is not used in any context in which the WHO code on the marketing of breastmilk substitutes is violated.

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If you value this service, kindly consider a donation to the Canadian Breastfeeding Foundation (registered charity). Earmark the donation for the International Breastfeeding Centre (Newman Breastfeeding Clinic) and/or the Goldfarb Breastfeeding Program.

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Donate by mail: Canadian Breastfeeding Foundation, 5890 Monkland Ave, Suite 16, Montreal, Quebec, Canada H4A 1G2.

© 2002-2019 Lenore Goldfarb, PhD, CCC, IBCLC, ALC and contributing authors to All rights reserved.

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