latching on

Latching On

Remember the 3 steps of latch-on: Positioning the baby, offering the breast and latching on.

Positioning: Use pillows to support your arms, back and the baby. If you are in a sitting position and your bottom is sore from the birth or you have incisional pain following a cesarean section: Put your feet on a low stool, slightly bending your knees. This will take the pressure off the sensitive areas.
Cradle Hold: Have baby turned toward you with the head in the crook of your arm. Baby's face, abdomen and knees should all be towards you. Baby should be level.

Football (or clutch) Hold: Have baby at your side, clutched next to you with baby's entire body turned in, toward you. Baby's feet should not touch back of chair/bed. Hold the base of baby's head, supporting the neck and shoulders. Your fingers should be below baby's ears.
Side Lying: Most women make the mistake of trying to breastfeed laying completely turned over on their side with their body at a 90 degree angle to the bed. This limits access to the breast and makes latch on difficult. To breastfeed laying down, it is best to put a pillow lengthwise behind your back (from just below your shoulders to the small of your back) and lean back on the pillow slightly. This will put you at more of a 45 degree angle to the bed. Place the baby on his side next to you, completely turned toward you. Use your lower arm to support the baby and bring him in toward the breast for latch on

With the opposite hand, hold your breast with all your fingers under the breast and your thumb on top. The entire hand should be behind the areola (dark portion of breast, behind the nipple). You will need to hold your breast while feeding.

Offering the Breast/Stimulate Rooting Reflex:
Move your breast gently, up and down. Keep "tickling" baby's lips with your nipple until the baby's mouth opens wide (like a big Ah . . . Or like a baby bird).

Latching-on: Center your nipple to baby's open mouth and pull baby in close. (This can be done by turning your wrist inward, rolling baby to the breast) Do this very quickly as one motion.
Baby's chin and lower lip should touch the breast first then the upper lip and gum.

Baby's mouth should cover most of the areola, not just the nipple. Do not push into your breast to clear a space for baby's nose. The tip of baby's nose should touch your breast. If baby's nose is not visible, raise baby's bottom half to a more level position or lift up on your breast slightly.

As the baby nurses, you should feel a pulling or tugging sensation. If it pinches or hurts, break the latch and begin the process again.
During the first few weeks, until you baby is better able to display his hunger cues it is best to use a modified cue feeding schedule. Feed the baby when he shows feeding cues or if more then 3 hours have passed since the start of the last feeding.
Often following birth baby may be sleepy as he recovers from the rigors of labor. If baby is having trouble staying awake at the breast, try a burp a switch technique: When suckling and swallowing slows or stops, burp the baby and offer the opposite breast.
Baby may not take both breasts at each feeding. Baby needs a minimum of 10 minutes of actual work (active suckling and swallowing) work per feeding.
Take the baby off the breast by inserting your finger between baby's gums and pulling downward to break the suction.
Feed baby immediately upon awakening.
Don't allow baby to become "frantic."
Keep pre-feeding stimulation to a minimum.

General Instructions:

Count number of wet diapers and stools daily. Good output of both stool and urine shows good milk intake.
By 5 days of age the entirely breastfed baby should have a minimum of 6 to 8 wet diapers and several yellow stools in a 24 hour period. Stools will become less frequent around 6 weeks of age but baby should continue to have 6 to 8 wets per day.
Eat 3 meals and 2 small snacks per day
Drink to thirst. Have something to drink at each feeding.
Rest frequently, don't over do.
Continue to take your prenatal vitamins for as long as you are nursing.
Watch for feeding cues
Nurse baby every 2 or 3 hours during the day.
Wake baby every 3 or 4 hours at night to nurse.
To encourage better night sleeping: wake the baby more often during the day.
Once you are sure that baby will wake for feedings when hungry (about 2 or 3 weeks of age) baby may sleep a six hour stretch at night, (example: 12 midnight to 6 am), if baby self wakes, it's OK to nurse.
Avoid bottles
Avoid pacifiers.