I had forgotten how totally clueless I was with my first child, until I talked with a pregnant friend of mine the other day.  She asked me if she needed to do anything special to get ready for breastfeeding.  Apparently, a friend of hers from work told her that she rubbed her nipples with a toothbrush to get them ready for breastfeeding.  All I could say was “Well, maybe they were really dirty or something,” and then bust out laughing.  My friend did not think that it was that funny, and I realized that she was being serious.  She needed help, and I am sure that she is not the only one out there that does.  Here are some basic tips to get you started:

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1. Initiate breastfeeding as soon as possible after birth.  This works best when you and baby are not drowsy from pain medication, so it is best to go unmedicated.  Most hospitals try to make sure you breastfeed within two hours of delivery, but I think within the first half-hour to one hour is ideal.  This is a time of quiet alertness for baby.  WABA suggests initiating breastfeeding within 20 minutes after birth.
2. Get in position with your back pretty straight up and down, not leaning backwards or forwards.  Get comfy and use pillows to support your arms and baby.  I love my Boppy Pillow and can not live without it!  You just don’t want to be straining to hold your baby up, because you could be there awhile!
3. Get your baby in position, situated right near the breast that you intend to use.  The baby should be on her side with her neck pretty straight and head supported by the crook of your arm.  This is where the pillows come in handy.
4. When everybody is comfy, you are ready to begin feeding.  For the first few feedings, you will probably want to cup your breast with the hand that you are not using to hold the baby, in order to offer baby the breast.  Your baby may instinctively begin to nuzzle you, lick, and open his mouth up wide.  If not, try tickling baby’s lips with your nipple to stimulate this reflex.
5. When baby opens wide, you will pull her to your breast quickly, being sure to get the entire nipple and a large part of the areola, or dark area around the nipple, into the baby’s mouth.  The baby’s tongue should be under the nipple, and both lips should be visibly puckered out.  If this is not the case, try again.  This may take some work, but eventually it gets much easier.  If the baby is latched-on properly, it should not be painful, and you will not be able to easily pull your nipple out of baby’s mouth.  It is like a vacuum.
6. You should be able to see the baby sucking, and can listen to hear if he is swallowing.   It will sound like a quiet “cuh” sound.  At first, only drops are coming out.  Literally, maybe 10 drops of colostrum, per feeding, and your baby may nurse for 10-45 minutes.
7. Once baby is tired of eating from one side, and un-latches, offer the other breast.  Baby may or may not want to eat more.  Just remember to always start the next feeding on the side last used (or the side that wasn’t used at all).
8. Feed your baby at least every 2-3 hours, and wake him up to eat if he does not wake up on his own.  That is common during the first few days.  You just want to be sure he is getting plenty to eat, and that you are stimulating your milk supply.  You should notice a wet diaper almost every feeding (hence the term “in one end and out the other”).  Stools will be variable, and may not even start within the first 48 hrs.

Remember, the midwife or the lactation consultant are your best tools to get breastfeeding off to a good start.   

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