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Positioning and attachment



Holding your baby against your skin straight after birth will calm them, steady their breathing and keep them warm. It will also encourage them to breast feed. Babies are often very alert in the first hour after birth and keen to feed. Your nurse can help you with this.

                                          Positioning and attachment

You can breastfeed in a number of different positions. Finding one that is comfortable for both of you will help your baby feed as well as possible. The steps below can help you get your baby to “latch” on to the breast to start breast feeding:

  • Hold your baby horizontally. Her forehead, shoulder and hip should be in a straight line. Make sure she is facing you. Support her neck and shoulders between your spread out fingers and thumb.

  • To start attachment properly, your nipple should be opposite your baby’s nose. Support your breast by placing your fingers underneath and your thumb on top, well away from the nipple area.

  • Gently tickle her top lip by brushing with your nipple. Wait until your baby’s mouth is wide open then quickly bring your baby to you, positioning the nipple under the roof of her mouth so that the nipple comes to rest at the back of the throat. Her chin will touch your breast first, and then her bottom lip should make contact on the areola (brown bit) well away from the base of the nipple.

  • You should now make sure that your baby’s cheek is just touching your breast. Her chin should be pressing into your breast and her nose should be clear. You should see some areola showing above her top lip.

  • Avoid holding your breast away from her nose with your fingers. If you are concerned that she can’t breathe, tuck her bottom in closer to your body. This allows baby’s nose to be clear of your breast.

  • Hold your baby very close to you until she starts sucking. Once she is doing long, slow sucks, your arm should be brought to rest underneath her.

                                        Positioning checklist

  •  The latch feels comfortable to you, without hurting or pinching. How it feels is more important than how it look.
     
  • Your baby’s chest is against your body and she does not have to turn her head while feeding.

  • You see little or no areola, depending on the size of your areola and the size of your baby’s mouth. If areola is showing, you will see more above your baby’s lip and less below.

  • When your baby is positioned well, her mouth will be filled with breast.

  • The tongue is cupped under the breast, although you might not see it.

  • You hear or see your baby swallow. Some babies swallow so quietly, a pause in their breathing may be the only sign of swallowing

  • You see the baby’s ears wiggle slightly

  • Your baby’s lips turn out like fish lips, not in. You may not be able to see the bottom lip.

  • Your baby’s chin touches your breast and her cheeks are rounded and plump filled with milk.

 Your baby is not properly attached if:
  •  You see pinched in lips or her cheeks being sucked in.

  • You hear clicking noises or lip smacking.

  • You feel pain in your breast throughout the feed

  • If this is the case, take her off the breast by sliding your finger between her lips and your skin, and try again.

                                    Getting off to a good start

The early days of breast feeding matter. You can be sure of getting off to a good start if you bear these key points in mind.

DO’S
  • Having as much as skin-to-skin contact with your baby as possible.

  • Breast feeding her as soon as possible after the birth

  • Making sure you are holding her well at the breast

  • Getting someone to check that her mouth is well attached at the breast

  • Feeding her as often and for as long as she wants

  • Having her by your bed

  • Getting help from a supportive nurse

DON’Ts
  • Offering extra feeds of formula milk will mean you will miss breast feeds, so produce less milk yourself. This will interfere with “supply and demand”. Your breasts may also become overfull and uncomfortable.
     
  • Using teats and dummies may confuse your baby and make it harder for her to learn how to breast feed

  • Offering water; it may fill her stomach up so that she has no room for breast milk; breastfed babies do not need water

  • Limiting time at the breast; it may mean that she does not get enough breast milk, and it interferes with supply and demand.
                                            
How do I know that my baby is feeding well?
  • Your baby has a large mouthful of breast.
     
  • Your baby’s chin is firmly touching your breast.

  • It doesn’t hurt you to feed (although the first few sucks may feel strong).

  • If you can see the dark skin around your nipple, you should see more dark skin above your baby’s top lip than below the bottom lip.

  • Your baby’s cheeks stay rounded during the sucking.

  • Your baby rhythmically takes long sucks and swallows (it’s normal for your baby to pause form time to time).

  • Your baby finishes the feed and comes off the breast on her own.

 How long should I breast feed?

Exclusive breast feeding (with no other food and drink) is recommended for around the first six months of a baby’s life. After this, you can carry on giving your baby breast milk alongside other foods for as long as you and your baby want. This can be into the second year or beyond.  For more information about introducing your baby to solid foods, go to our section on weaning.

Every day you breast feed makes a difference to you and your baby. There is no need to decide at the beginning how long you will breast feed. Many mothers continue to breast feed if or when they return to work. The practicalities will depend on how old your baby is and how many feeds they need while you are apart, but it’s often easier to manage than people think.


How will I know when my baby is hungry?

After a while, you will get to know the signs that mean your baby is ready to feed. Most babies will signal that they are hungry by opening and closing their mouths, making sucking noises, opening their eyes or turning their heads to bring their mouth towards you. By the time a new born baby starts crying, they will normally have been hungry for a while.


How do I know my baby is getting enough milk?
  • Your baby should be healthy and gaining weight.
     
  • Your baby nurses every 2 to 3 hours, has 6 to 8 really wet diapers per day, and is gaining weight  appropriately (about 1 pound each month).

  • In the first 48 hours, your baby is likely to have only few wet nappies. Wet nappies should then start to become more frequent, with at least six every 24 hours from day 5 onwards.

  • Most babies lose weight initially. They should be weighed by your doctor sometime around day 3 to 5. From then on, they should start to gain weight. Most babies regain their birth weight in the first two weeks.

  • At the beginning, your baby will pass a black tar-like-stool (poo) called meconium. By day 3, this should be changing to a lighter, runnier, greenish stool that is easier to clean up. From day 4 and for the first few weeks, your baby should pass at least two yellow stools every day. These stools should be at least the size of one rupee coin. Remember, it’s normal for breast fed babies to pass loose stools.

  • Your breasts and nipples should not be sore. If they are, do ask for help.

  • Your baby will be content and satisfied after most feeds and will come off the breast on their own.

  • You can also listen for swallowing during feeding (the baby will usually swallow about every third suckle).


    Remember:


    Breast feeding should feel comfortable. Your baby should be relaxed. You should hear a      soft swallowing.  If it doesn’t feel right, start again. Slide one of your fingers into your baby’s mouth, gently break the suction and try again. If you stop breast feeding, it can be difficult to restart. Giving formula milk to breast fed baby can reduce your supply of breast milk.




 

 



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