If you follow this lactation consultant’s guidance, you and your baby will be off to a "suck-cessful" start.
August is National Breastfeeding Awareness Month, a topic that Bonsie Skin to Skin Babywear is very passionate about. Breastfeeding and skin-to-skin contact are closely connected because of the ways that skin-to-skin contact contributes to breastfeeding success. Both of these nurturing acts provide a cascade of benefits for mom and her baby, and we strongly believe that the world would be a better place if mothers simply had more time to cherish these loving moments together.
Here’s a snapshot from the book The Nurture Revolution, by Greer Kirshenbaum, PhD (we highly recommend it), that perfectly highlights why breastfeeding gets us so fired up:
Breastfeeding “continues to build your baby’s stress system, immune system, and their mouth palate (which is also vital to the developing stress system and brain development). Plus, it provides you with the benefits of oxytocin for every single feed. It is comfort, nourishment, development, health, and closeness. Comfort is not extra, unnecessary, or spoiling; it is vital to building your baby’s brain. There is no downside to breastfeeding or body feeding for all of infancy and beyond.”
Greater breastfeeding education and support are desperately needed for new moms, so we are providing you with priceless information from the most inspiring lactation consultant we know. Summer Friedmann is an IBCLC with her own private practice, called Done Naturally. She also has her own YouTube channel and Facebook group where she shares short videos and vital information to help moms all over the world reach their breastfeeding goals. In the content below, Summer shares what she wishes she had known as a new mom, now with 18 years of experience as an IBCLC and mother of three. (You’re going to want to bookmark this article!)
Breastfeeding Orientation
Breastfeeding. That one word can elicit some strong and often polarizing feelings. (And yes, it is one word, not hyphenated.) Here you are, having just set eyes on your newborn baby, and what comes next? I prefer to call the first feeding an orientation. The first two hours of life are when your baby’s suckle reflex is at its highest, and we can take advantage of that by bringing your baby to the breast. You might be wondering: Will it be perfect? Will it hurt? Do I have to help? What should I do? What will it feel like? How will I know if everything is okay? We all have these thoughts at this moment. These thoughts were in my mind when I had my first baby 22 years ago. I was full of questions as a first-time mom before I began my career as a lactation consultant.
Why do I call the first feeding an orientation? I want to help set up realistic expectations for you. Your baby may latch right on, they may struggle, you may help them, you may struggle, they may be too sleepy, or they might just lay next to the breast. Maybe they just lick, stick out their tongue, look up lovingly at you, and fall asleep. So, rather than telling you to expect your baby to have their first feeding after birth, what I want you to do is to offer an orientation of the breast. Essentially, you are setting up the environment for a feeding, and you should not be worried if they don’t latch or are too sleepy. We just want your baby around the breast.
Skin-to-Skin Contact
One of the best ways to orient your baby to the breast is by placing your baby skin-to-skin. This can happen immediately after birth, without the need to wipe your baby with a towel. You are the only home your baby has known, and the transition from a water world to our breathing world is a big one. Your baby now has to regulate blood sugar, body temperature, and drink. These are all things your body did for your baby in the womb. To ease that transition, place your naked baby on your bare chest. Just like magic, your body regulates their body temperature, raises their blood sugar, and triggers their instincts to root and look for the nipple for latching.
The mother’s body has superpowers beyond milk making, believe it or not.
Her body functions like a thermostat. If the baby is too cool, her body will raise its own body temperature to warm up the baby. If the baby is too warm, her body will lower its body temperature to cool down the baby. Now, how about the blood sugar regulation? It can be a shock to the baby’s system to move from constant feeding by the umbilical cord to now having to put in effort to get food out of the breast. Just by being on the mother’s bare chest, a baby’s blood glucose will rise and stabilize. It is as if the mother is working as a bridge to allow the baby time to learn, figure things out slowly, and soak in finally meeting you. The mother’s body and the baby are working in harmony as the newborn’s body learns how to do those things independently on the outside.
The takeaway here is there is no rush to latch the baby. A full-term newborn is not born starving. They have excess stores of fat to allow them time before they need to eat. Interestingly enough, skin-to-skin (also called kangaroo care) only works if the baby’s full trunk or chest area is in direct contact with the mother’s bare chest (mom should not be wearing a bra or gown). Their bodies must be sandwiched together without anything between them. The baby also has to be upright between the breasts with their head under the mother’s chin. Studies have shown that the medical benefits of skin-to-skin do not occur when the baby is lying across the mother’s body, across the breasts horizontally. There is more surface area covered when the baby is placed between the breasts and upright.
The Breast Crawl
Another miracle to see is self-attachment and what is called the breast crawl. This is when a baby is placed on the mother’s abdomen, the mother is deeply reclining, and the baby will literally crawl up to the breast, find the nipple on their own, and attach without any assistance. Studies have shown this is less likely to occur when the mother has medications during labor. But I have certainly used this technique with my patients after a medicated delivery and WOW, just WOW! Every time, it brings tears to my eyes. Seeing the baby knead their bent knees into her belly, press their fists, and slink their body up her belly, up to the breast, is the coolest thing. They smell the colostrum and the oils the areola secretes, which helps direct them, and then you’ll see them brush the side of their face with the nipple and keep moving their body until they are just right where they need to be. Many times, when babies self-attach in this way, their latch is perfect.
Latch
Latch. Whoosh. That’s a biggie. How many times does that word come across your phone screen as you are scrolling on Facebook, ‘The Gram,’ or TikTok?!
If you haven’t heard it yet, hear it now: breastfeeding should never hurt. Ever.
If you’re having pain, something is not right. If you hear someone say, ‘Well, everything looks fine, so they must be latched well,’ fire them. What you should feel is tugging, pulling, stretching, strong sucking, pressure, or yanking. What you shouldn’t feel is slicing, cutting, pinching, or anything that makes you want to pull that baby off immediately. I tell my families they should be able to talk and breathe normally while the baby is nursing. They should not be gripping the side of the bed or chair, we shouldn’t see any toes curling, and we shouldn’t see the mother’s face scrunching up or squinting her eyes.
There will be no doubt the latch is wrong if there is a sense of urgency in your body. If you are wondering if this latch is right as the baby is nursing, and you are calm, it is probably right. Now, you might ask what a good latch looks like. I may blow your mind here: it doesn't matter what it looks like! What matters is what it feels like. In fact, close your eyes and feel—that is how you know. There is no need to investigate with your fingers, pushing your breast tissue around and searching for lips, chin, or anything. If I see a latch that isn’t ‘by the book perfect,’ but mom is comfortable and I see the baby swallowing in a good steady pattern, I leave everything alone. We do not fix what is not broken. If I see a latch that looks great but mom is screeching, twisting her toes, and holding her breath, something isn’t right no matter how great that latch looks. Assessment, correction, and assistance by the IBCLC is the next step.
Writing about what a latch is supposed to look like will never compare to being with someone and observing a feeding. But in general, the baby’s mouth is open as wide as possible, the nipple is aimed at the roof of the mouth, the baby’s eyes are able to easily gaze up to yours, their head is tilted back, the nose is clear of the breast, and the chin is pressing into the breast and usually not visible. What about positions? Which is best? The best one is the one that you feel most comfortable in, and no, you do not have to practice every single one. Find what is working and keep doing that. It is better for you to get good at one than always changing and being sorta okay with many. After some time passes, you’ll be able to latch and nurse that sweet baby in any position without even thinking about what you are doing.
Milk Supply
Next up, milk supply and the common worry of making enough milk. These beginning days and weeks are critical to establishing a healthy milk supply. If you haven’t heard that milk supply is supply and demand, or that milk removal makes more milk, I fear you may be living under a rock. Tee hee hee. Everyone seems to understand that now, but the trouble is that the classic message is getting murky with other mixed messages. People are overwhelmed with misleading suggestions from influencers, businesses, marketing, and basically anyone who profits from you. I’m talking about lactation cookies, special drinks, pills, concoctions you buy online, special foods, teas, and powders. Those things are not milk makers and make zero sense from a physiological standpoint. Breastfeeding is accessible to all, regardless of where they live in the world, what money they do or don’t have, and it certainly doesn’t make sense that one would have to purchase something in order to make milk.
People who live in underdeveloped parts of our world have babies, breastfeed, and make ample milk without having access to any of these first-world options. Science proves these gimmicks are just that—bogus and only taking advantage of vulnerable parents who just want something to work and are desperate to buy anything. The one and only true thing that will tell your body to make milk is taking milk out of the breast. And this job belongs to your newborn baby.
Babies are born with small stomachs, and in the first day of life, they hold as little as 5-6 ml—that is one teaspoon! Tiny tummies fill up quickly but empty quickly. So that means the baby will be nursing very frequently. They are not nursing every 3 hours; they are nursing every hour! As your milk supply and their stomach grow, they start getting more milk when they nurse, and then they may be nursing every 2 hours or have some 3-hour stretches. But in the beginning weeks, it is best to expect nearly constant feeding as they build what I call "The House of Milk."
Because milk supply is driven by removal, the more the baby nurses, the more milk you will make. This makes it incredibly important that you let the baby drive, so to speak. Never say no to a feeding cue; always say YES and allow for unrestricted access to the breast. In other words, breastfeed ON DEMAND.
As a lactation consultant, I love a baby who is energetic, waking often on their own, vigorous, and feeding a lot. I am worried about a sleepy baby who needs to be woken up to feed and then is sluggish and lethargic. In these early days, paying attention to how many wet diapers the baby is having is important. Tracking poopy diapers and the color changes tells us about your milk moving from colostrum to mature milk, and if your baby is getting enough milk. And guess what?! Colostrum is a natural laxative that helps a baby poop.
Jaundice is something newborns can struggle with and is a buildup of bilirubin that creates yellowing of the eyes and skin and makes the baby very sleepy. Again, magically, the mother’s body fixes this. Bilirubin is excreted from the body through poop! So the more pooping the baby does, the better. This means the more they nurse, the more they poop, the more milk you will make, and the bilirubin comes out faster, which lowers jaundice levels. Isn’t it nice how that works so well together?! Nature is so dang smart.
Sleep
What about sleep, you ask? I don’t have great news there, sadly. From now on, even when your baby is a teenager, sleep is a challenge, just now with big world problems. But will your baby sleep? Yes. It will be fragmented sleep. Babies are wired to feed, not sleep. If babies slept long stretches, they wouldn’t stimulate the breast to make milk, they would lose weight, and not thrive. Learning to nap during the day is very helpful, so when the baby is resting, you can too. Even a short 1.5-hour nap can help you get through the middle of the night. Babies naturally feed more in the middle of the night and sleep more during the day. I know, I know—terrible design by whoever is up in the stars. There is a good reason behind it.
A mother’s milk supply is highest between about midnight and 9:00 a.m. So, she makes most of her milk during those hours rather than the remaining hours of the day. This is driven by her lactation hormones and the surge that happens in the middle of the night. A baby is instinctual and therefore wakes for feedings often during this time. Do they eventually start doing longer stretches at night? Yes, of course. Should we force a baby to sleep rather than feed in the middle of the night? NO. That will only jeopardize healthy growth for the baby, reduce the mother’s milk supply, and nudge both baby and mom to early weaning.
Unforeseen Challenges
Okay, Summer, this is all great, you say. But what if nothing goes as planned, you did your research, and you miss out on skin-to-skin, the baby couldn’t latch, you have pain, you’re pumping, or the baby had to be separated from you? Don’t freak out. In my 18 years in this lactation gig, I have had moms get through all sorts of challenges—from giving birth at 24 weeks, Down syndrome, clefts, very broken nipples, twins, triplets, quads, and other things.
You and your baby are wired to do this. The best thing you can do is be prepared and surround yourself with qualified professionals and people who will encourage you along the way. Never ever hesitate to reach out if things are not going well, you’re worried, or unsure. If you get someone that isn’t very helpful, don’t give up searching. There is someone out there who will be helpful, will listen, and will get you through.
I know firsthand. My first encounter with a lactation consultant was with my son in 2002, and it was horrendous. I succeeded in my breastfeeding journey, not because of her, but because of my mom, a breastfeeding support group, and the book The Womanly Art of Breastfeeding. Crazy enough, I am grateful for my terrible lactation consultant; she is why I chose this career path. I wanted to be different, be better, and be a part of the solution. So believe me when I say, YOU CAN DO IT, even if things don’t get off to a flying start. Find the person, the group of people, or the book, and let them show you how to spread your wings. It’s glorious!
For more information about Summer Friedmann, check out her Instagram page and give her a follow! You'll be happy you did:
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