Early breastfeeding requires more focus, more effort, more hands on, more ‘props’ than the later, easy, multitasking breastfeeding that is to come. Breastfeeding is the most labor intensive the first month. The first 24-48 hours involve learning to latch & suck well at the breast- a time to practice when baby doesn’t require a lot of volume, and in fact isn’t ready to digest large volumes based on stomach capacity and other factors.
When you begin to breastfeed, you first have to set up or stage your feeding session. Empty your bladder, have your glass of water nearby, be sure you’re medicated if you have pain from stitches or an incision. Sit with good back support; try not to hunch over the baby. Use firm pillows to support baby so he/she directly faces the breast when latching.
There are two mechanics involved in good feeding: latch and a rhythmic, effective suck/swallow pattern.
Step one is latch. Babies should latch to the areola so they can compress where the milk ducts end with their gums which is how they actually eat. And babies should latch to the areola because that is where moms have far less nerve endings; it is far more comfortable for moms when babies latch to the areola and far less comfortable when they latch to the nipple only. Don’t hesitate to bring your baby in quickly to latch to the areola when he/she opens widely because babies open their mouths and close them quickly so you have to move quickly to facilitate a deep, comfortable latch.
Step two is sucking. Two things keep a baby on breast: the tactile stimulation (the feeling, the shape) of the nipple in their mouth AND milk or colostrum flowing. First babies sense the nipple on the roof of their mouths which elicits their sucking reflex. Once they’ve latched, they need to suck rhythmically; the early breast has low volume (which is appropriate) which is why we use breast compression to help the colostrum or milk flow; this will engage the baby in a rhythmic suck/swallow pattern.
The things moms do to facilitate latch and sucking are integral to breastfeeding; you’re dance partners, you each do certain things in the dance. To facilitate latch, moms hold the baby firmly with the heel of their hand on the baby’s upper back. Using thumb and fingers to cup the base of the baby’s head beneath each ear from behind the head allows you to hold the baby close enough to sense the nipple, open his/her mouth to root, and then quickly move the baby closer to the breast to latch to the areola.
To facilitate both latch as well as baby’s suck moms use their second hand to support their breast at the chest wall (where your bra would hit). This allows moms to point the nipple to help baby latch and to then compress or squeeze the breast gently to help the colostrum or milk flow. Moms respond to babies sucking in this way; when the baby pauses, after 3-5 seconds, relax and re-compress the breast to provide more flow, babies in turn respond by sucking. This cycle repeats multiple times.
It seems strange to talk about it in words, like describing how to ride a bicycle without getting on a bicycle. The real learning curve begins when you have your sweet baby in your arms. You both begin to learn how to breastfeed at that time. The good news is you really have the first 48 hours to ‘practice’ and begin to figure it out. Remember women have always taught other women how to breastfeed so never hesitate to ask for help; ask you sister, your friend, your nurse, and most importantly call a lactation consultant if you need to!