Breastfeeding: Basics and Tips for Nursing Your Baby

They make it look so easy, those breastfeeding moms you’ve seen. Without skipping a beat of conversation or a bite of lunch, they open a button and latch on a baby, as if breastfeeding were the most natural process in the world. But while the source may be natural, nursing know-how — especially for newbie moms and their babies — often doesn’t come naturally at all at first.

Whether your first time is a breeze, something of a struggle or somewhere in between, there’s a lot to learn. So the more you know about technique (how to position baby), mechanics (how to know baby is getting enough milk) and logistics (when a meal is over and when it’s time for another), the more confident and empowered you’ll feel.

Once you get past the initial trial-and-error days of finding the best system for you, nursing becomes one of motherhood's most rewarding responsibilities. And breastfeeding offers lots of benefits for both you and your baby — giving both of you a head-start on a healthy future.

Breastfeeding 101

To raise your breastfeeding IQ before you start nursing, take this mini-course in breastfeeding basics.

When your milk comes in

Breast milk arrives in three stages. Nature designed each for your baby’s age, making it the perfect food from the first day to the tenth and beyond:

• Colostrum: When you first deliver, milk hasn't yet arrived on the scene. The thick, yellowy (though sometimes clear) substance that you’re producing is colostrum, the same stuff that leaked out of your breasts during pregnancy. This vital blend of protein, vitamins and minerals can also help defend against harmful bacteria and viruses, and possibly even stimulate baby to produce antibodies. It also coats the inside of baby’s intestines, protecting her immature immune system, and protecting against allergies and digestive upset. Plus, it stimulates baby’s first bowel movement and reduces jaundice risk. You'll likely make very little, but baby probably won't need more than a few teaspoons of this "liquid gold" per feeding during the early days. Regularly suckling from the start will help stimulate your body to produce the next stage of milk within a few days.
• Transitional milk: Next on the tasting menu is transitional milk, which your breasts serve up between colostrum and mature milk, usually around the third or fourth day. It resembles milk mixed with orange juice — but fortunately tastes a lot better to your baby — and appears when your milk first "comes in." It contains lower levels of immunoglobulins and protein than colostrum but has more lactose, fat and calories. And don't worry if it doesn't seem like you're producing a lot of milk — at day 3, baby's stomach is only the size of a walnut.
• Mature milk: Arriving between day 10 and two weeks postpartum, mature milk is thin and white, though sometimes slightly bluish. While it looks like watery skim milk, it’s packed with all the fat and other nutrients that growing babies need.

Latching baby onto your breast

In the beginning, it might take quite a few tries to get your baby into the right position — but keep trying.

First, it’s essential to know a good latch, since improper latching is the most common cause of breast discomfort. Baby's mouth should cover both your nipple and the areola, so that baby’s mouth, tongue and lips massage milk out of your milk glands. Sucking on just the nipple will not only leave your infant hungry because the glands that secrete the milk won’t be compressed, it will also make your nipples sore and cracked. Here’s how to get that latch going:

• Hold your baby facing your breasts, with the front of her body facing yours, tummy to tummy. Her head should be in line with the rest of her body, not turned, to make swallowing easier.
• Tickle baby's lip with your nipple to encourage baby to open very wide, like a yawn. If your baby isn’t opening up, try to squeeze some colostrum, and later, milk, onto her lips.
• If your baby turns away, gently stroke the cheek on the side nearest you. The rooting reflex will make baby turn her head toward your breast.
• Bring baby forward toward your breast once her mouth is open wide. Don't lean over and push your breast into baby’s mouth — let your baby take the initiative. Keep a hold of your breast until baby has a firm grasp and is suckling well.
• You’ll know you've got a proper latch when baby's chin and the tip of her nose are touching your breast. Baby’s lips will be flared outward, like fish lips, rather than tucked in. Check that your little one isn’t sucking on her own lower lip or tongue — newborns will suckle anything — by pulling her lower lip down while nursing.
• Watch for suckling — that is, extracting colostrum or breast milk from your breast, not just sucking or gumming your nipple. If baby is suckling, you’ll see a strong, steady suck-swallow-breath pattern. You’ll also notice a rhythmic motion in baby’s cheek, jaw and ear. Once your milk comes in, listen for the sound of swallowing or gulping. You’ll know baby isn’t latched properly if you hear clicking noises.

Is baby having trouble properly latching on? Break the suction carefully by gently inserting a clean finger into the corner of her mouth or by pressing on your breast near the mouth. Then begin the lip tickling anew and let her latch on again properly, with the nipple and the areola in the mouth.

How long to breastfeed

While you may have heard that short feeds prevent soreness and cracking, that usually doesn’t come from feeding too long but from getting into a less-than-ideal position. So instead of setting time limits on each feed, let your sweetie take her time at the breast — and expect feedings to be long initially.

• Sessions typically last 20 to 30 minutes. But keep in mind, that’s on average. Your baby could take more or less time and need to feed for longer in the beginning and during growth spurts.
• Drain one breast fully. Ideally, at least one breast should be well-drained at each feeding. This is more important than being sure baby feeds from both breasts, since hind milk — the last of the mature milk that baby feeds on — is richer in fats and calories. So don’t pull the plug arbitrarily. Instead, wait until your baby seems ready to quit on breast one, then offer, but don’t force, breast two. If baby drains one breast and doesn’t want any more, start with the other breast at the next feeding.
• Wait for baby to signal she’s done. End the feeding by waiting for baby to let go of the nipple. If your baby doesn’t, you’ll know to end the feeding when the suck-swallow pattern slows down to around four sucks per one swallow. Often, your baby will fall asleep at the end of the first breast and either awaken to nurse from the second or sleep through until the next feeding. Again, unlatch by pressing on your breast near baby’s mouth or carefully inserting a clean finger into the corner of your infant's mouth.

How often to breastfeed

Feeding babies when they’re hungry (on demand) rather than on a schedule is ultimately best for breastfeeding success. But since babies usually aren’t born hungry — their appetite generally picks up around the third day — chances are there won’t be much demand at first. Which means you may have to initiate — even push — at first.

A newborn should have at least eight to 12 feedings each 24 hours, even if demand isn’t up to that level yet, for the first few weeks. Break that down and you’ll probably be nursing every two to three hours, day and night, counting from the beginning of each nursing session.

Feeding patterns vary widely from baby to baby, however, so you might need to nurse a little more or less frequently. If you have a hungrier or more impatient infant on your hands, you may go little more than an hour between feedings; a more easily satisfied baby might be able to go for three-and-a-half to four hours. If you feel like you're nursing constantly, don't worry; it's temporary. As your milk supply increases and your baby gets bigger, the breaks between feedings will get longer.

Don't be concerned or surprised if your formula-feeding or supplementing friends say their newborns eat far less often. Breast milk is more easily digested than infant formula, allowing the tummies of nursing babies to empty faster — and thirst for more sooner.

Signs baby’s hungry

A good way to master the right breastfeeding balance is to nurse when your baby seems hungry. Don't wait for tears; by then, your little one may be uncomfortably hungry, especially the longer she cries. She might be tiny but she'll make her needs known by:

• Nuzzling against your breasts
• Sucking furiously on that little baby hand — or your shirt, or your arm
• Opening her mouth
• Rooting, when baby opens her mouth and turns her head to the side with her mouth open to find the food source, often after her cheek is stroked
• Sucking on her lip or tongue, which can look like she's sticking her tongue out
• Making lip-smacking sounds
• If she does cry, it will typically be a short, low-pitched wail that rises and falls

Breastfeeding positions

Your hospital will likely teach you the basic cradle hold. But with some trial-and-error, you might find another breastfeeding position works better for you and your baby. Here's the lowdown on all the basic breastfeeding positions:

• Cradle hold: Position your baby so that her head rests in the bend of your elbow of the arm on the side you'll be breastfeeding, with the same hand supporting the rest of baby's body. Hold your breast with your opposite hand and compress it very gently so that the nipple points toward baby's nose.
• Crossover hold: Hold your baby's head with the hand opposite to the breast you’ll be nursing from. For example, if nursing from the right breast, hold the head with your left hand. Using your free hand, cup your breast as you would for the cradle hold.
• Football hold: Your baby's legs are tucked under your arm on the same side as the breast you're nursing from. Hold your baby with that arm on a pillow to lift her up, and use your other hand to cup your breast.
• Side-lying position: A good position if you’re nursing in the middle of the night. Lie on your side with a pillow under your head. Baby should face you, head in line with your nipple. Use your hand on the side you’re not lying on to cup your breast if you need to. You may want to place a small pillow behind your baby’s back to hold her close.
• Laid-back position ("biological nurturing"): In this position, you lean back comfortably, semi-reclined, on a couch or bed with pillows supporting your upper back, neck and head. Place baby on you, tummy to tummy, lying on your chest in pretty much any direction that's comfortable, with the baby’s cheek on your breast. Your little one's weight will be supported by your reclining body. The idea with this nursing position is to take advantage of gravity and naturally let baby seek out your nipple, but you can also hold your breast and point it toward baby to encourage latching. This is a great breastfeeding position for newborns, babies who spit up a lot, and infants who are gassyor have ultra-sensitive stomachs. It also leaves your hands freer to cuddle with and caress your little cutie.

How to tell if your baby is getting enough milk

Many new nursing mothers worry at some point that baby isn't eating enough. Your breasts aren't calibrated on the outside, after all, so you don’t know how much milk you’re producing and baby is consuming. If you’re concerned, a few indicators can help you check that your baby is getting her fill:

• Disposition: If your little one seems happy and content after most feedings, then chances are she's a satisfied customer and is getting enough milk. If she's crying and fussing or sucking on her fingers frantically after a full feeding, she might still be hungry (though these can also be signs of gas or infant colic).
• Dirty diapers: Keep a careful count. After three or four days, your newborn should be pumping out at least six and up to 12 with clear to very pale yellow urine and at least three or four soft, yellow bowel movements over a 24-hour period in the beginning. For the first several weeks, it's a good idea to keep a record of breastfeeding frequency and diaper output, which you can bring along to the pediatrician's office at each visit.
• Weight: Infants should gain weight steadily every week from the second week on; 4 to 7 ounces per week is typical for newborns, although weight gain varies depending on age and other factors. Your pediatrician will let you know if your baby's growth is on track.

Breastfeeding tips

Nervous about getting started? These tips can help give you more confidence and ensure you and baby get the most out of the experience:

Before you deliver

• Learn all about it. Reading up can help you get a leg up, even before you have your baby and get started. Consider a breastfeeding class — offered by many hospitals, lactation consultants or your local La Leche League — which can teach you everything from how to latch and boost your milk supply to how to troubleshoot and involve your partner.
• Get a room. The more time you and baby spend together in the hospital, the easier getting together for feedings will be, since that way she can nurse on demand. So put in a request in advance of your birth for full-time rooming (that is, sleeping with you instead of in the newborn nursery), if possible, or partial rooming-in days (not nights). If rooming-in isn’t an option or you decide to opt out of it, just ask to have baby brought to you whenever she’s ready to feed, or about every two to three hours, at least during the day.

At the hospital

• Get an early start. Babies are born ready to breastfeed and show extra eagerness to suck during the first two hours after birth; the sucking reflex is at its most powerful about 30 to 60 minutes after birth. So plan to breastfeed as soon as you can, assuming you and your new arrival are up to it. But don’t stress if it doesn’t happen right away — just catch up as soon as it’s practical.
• Work the system. Hospital nurseries are busy places, so it’s not surprising that staff can be quick to calm a fussy baby with a bottle. But breastfeeding from the get-go helps stimulate your supply, plus baby doesn’t get used to the easier yield of an artificial nipple versus your harder-to-work breast. So take the initiative when it comes to breastfeeding your baby if you decide to try nursing exclusively from the start. Explain your preferences to the staff.
• Talk to a lactation consultant. Before you leave the hospital or birthing center, you might be able to schedule a visit with one or take a class so a pro can observe you feeding your baby, make sure you're on the right track and check that your baby is getting enough milk. If you don't see a consultant, feel free to ask for one; she can also offer tips on caring for nursing breasts and expressing milk, along with literature to take home — so don’t be afraid to ask plenty of questions.

When you get home

• Seek peace and quiet. Until breastfeeding becomes secondhand, you’ll need to focus during feedings. So get settled in an area with few distractions and low noise levels. When you get more comfortable breastfeeding, you can keep a magazine, phone or tablet nearby to keep you occupied. Just don’t forget to put it down from time to time to interact with your little nurser — it’s good for both of you. Try to avoid watching TV or talking on the phone during the first few weeks too, until you get the hang of it.
• Get comfy. Settle in a position that’s comfortable for you and baby: on the couch, in an armchair or glider or in bed, either propped up or lying down. If you’re sitting up, a pillow across your lap helps raise baby to a comfortable height and prevents baby from putting pressure on an incision site if you’ve had a cesarean. Prop up your arms as well, since trying to support baby on your own can cause arm cramps and aches.
• Quench your thirst. Have a cool drink — milk, juice or water — by your side to replenish fluids as you feed; just avoid hot drinks in case of a spill. And, if it’s been a while since your last meal, a snack.
• Practice, practice, practice. Your supply is tailored to your baby’s needs in those first few days of life, and those needs are minimal and usually easily filled by colostrum. So consider those early feeds "dry runs" — a chance to perfect your technique while your milk supply builds up. Keep the rehearsals going once your milk comes in too.
• Switch sides. Start each feeding on the breast that baby didn’t nurse on at all last time or that didn’t drain completely. As a reminder, you can tuck a nursing pad or tissue into the bra cup on the side that you didn’t nurse the last time, which will also protect from any leakage your breast is letting down in anticipation.
• Keep it up. You might be tempted to stretch out the time between feedings, but try to resist: Milk production is influenced by the frequency, intensity and duration of sucking, especially during the first few weeks. Cutting down on frequent demand, cutting sessions short or letting baby sleep too long between feedings, especially during the day, can quickly sabotage your supply.
• Soothe chapped skin. A little organic olive oil or coconut oil can help ward off cracked or chapped nipples — and keep you breastfeeding comfortably. A nipple shield can also help with pain.
• Give it time. Keep in mind that baby is a nursing rookie, and you are too (if this is your first time or even if it isn't since all infants are different). You both have a lot to learn before you’re in sync, even if you’ve successfully nursed another baby before.
• Keep your cool. Feeling a little overwhelmed? That’s natural. But tension can inhibit let-down of milk. So if you’re feeling on edge just before a feed, try to chill out with a few relaxation exercises — maybe the same ones you used during birth: take a few deep breaths, close your eyes, listen to music. Your baby will likely be relaxed by your vibes, too.

Getting breastfeeding help

Looking for breastfeeding support ahead of time? Or want help getting over a glitch? There are many breastfeeding problems experts and experienced peers can help you solve, from a poor latch to mastitis, breast engorgement and more. Here are some reliable resources you can call on:

• Your baby's doctor
• A lactation consultant
• A nurse who specializes in lactation
• A postpartum doula
• Local mom groups or breastfeeding support groups
• Friends and family members who have nursed, who will likely be happy to offer you an ear and reassurance that the bumps do eventually smooth out
• International Lactation Consultant Association (1-888-452-2478)
• La Leche League International (877-4-LALECHE)
• National Women’s Health and Breastfeeding Helpline (800-994-9662, 9 am to 6 pm)

If you’ve sought out professional help and are still having trouble breastfeeding, remember that it’s not an all-or-nothing proposition. Talk to your doctor about whether you should consider supplementing with formula or formula-feeding. Remember: What babies really need is love and attention from you — and that doesn’t come from breast or bottle.