Day One: The Big One
"You're feeling kind of rollercoaster of emotions," says Dr. Ann Kellams, M.D., head of the nursery at the University of Virginia Medical Center in Charlottesville, Va. "Nothing went the way you planned because the best laid labor plans and birth plans can go out the window when you end up in that delivery room."
First problem solved? Let your partner, the doctor — anyone but you — tell the family in the hall the big news, and make them wait outside. It's time for everyone to get naked. Really.
"There is plenty of evidence that babies who breastfeed within the first hour of life do better," Kellams says.
The best way to make that happen, according to breastfeeding success plans devised by the World Health Organization and UNICEF, is for mom and baby to have skin-to-skin contact as soon as possible after the baby is born. That means no top for you, no swaddling blankets for baby. And it means no squadron of relatives piling in to cuddle and coo.
Hospital maternity wards are moving more toward the skin-to-skin concept, but it's still common at many birthing facilities for nursing staff to immediately hustle babies off to a bath and wrap them tight in blankets. The concept takes some getting used to for mothers, Kellams pointed out, but the baby will actually use the familiar scent of Mom to work his or her way to the breast and make that first, practice latch.
"Practice is as much for the baby as it is for you."
"That first twenty-four hours, you're just going for practice," Kellams explains. "They might just get one ounce of milk all day, and that's fine."
Practice is as much for the baby as it is for you. You just went through labor, and so did they — a baby who goes to sleep for eight hours after that first feed is fine, says Laura Keegan, a family nurse practitioner in private practice in upstate New York and author of Breastfeeding With Comfort and Joy. In that first day, as long as the baby is awake, Keegan suggests letting the baby to the breast as often as possible, but the average is probably going to be closer to three feeds in twenty-four hours than the standard "every two hours" of your standard breastfeeding manual.
"However, you may bring the baby to the breast more often than this, attempting to nurse every 1-1/2 to three hours from beginning of feed to the beginning of the next feed," Keegan says. "These frequent attempts allow both of you time to practice the first couple of days."
You're going to need it. Because every baby and mom have the perfect latch — a position just right for the baby's mouth and the mom's breast size and shape that will enable the baby to get enough milk without pain for the mother. Kellams and Keegan agree — breastfeeding shouldn't hurt.
Related Resources
Getting Started Breastfeeding, on KellyMom
Breastfeeding Instructional Videos
Dr. Jack Newman's Latching Guide
Lactation Consultant Directory, on ILCA
Until you find that right latch, however, breastfeeding most definitely does hurt. Michelle Manuel, a mom of two from Kansas City, Missouri, had cracked and bleeding nipples for days after her son was born.
She remembers calling on a nurse to help her get her sleepy newborn son to latch on, only to be told it was "easy."
"Finally after an exhaustive, emotional hour-plus of trying things the way she suggested, I called her back into the room. Her response to my feeling of helplessness? 'Well, you'll just have to keep trying,'" Manuel recalled. "I know now that if I had napped for that hour (and so had he) in the hospital that we might have both been better rested and more ready to take up the task. Instead I was worried about doing it right and by the book, and I ended up exhausted and frustrated.
"I also wish I'd realized that while many labor and delivery nurses are wonderfully gifted, not every one is a lactation consultant. It would have been okay for me to ask for a nurse with more experience in lactation on duty at that time, or asked to have the lactation consultant come first thing in the morning."
Unfortunately, Keegan says, many mothers are looking for a "right" way — but every baby is different, and so is every mother.
"If you are finding you are having discomfort or pain during the feeds, it is important to focus on your positioning and how the baby is taking your breast," she says. "You do not hold your baby to breastfeed the way you hold your baby to bottle-feed. When we breastfeed in a bottle-feeding culture, we tend to bring the baby's head too far to the breastfeeding side of our lap and center the nipple in the baby's mouth.
"What we want to do is hold our baby more to the center of our lap than we might expect, the way a little girl holds a doll in the center of her lap . . . When we bring the baby to the breast, the nipple should point to the baby's nose or upper lip depending on how wide the baby opens her mouth. When you do this, the nipple ends up in the roof of the baby's mouth where there is no friction, therefore no pain."
Mothers who already have cracked or sore nipples from repeated attempts to get things right might feel pain as the nipple is drawn in. That, alas, is normal. "The baby does not just latch on and the music plays," Kellams concludes.
©2009 Jeanne Sager and Babble
About the Author
|
|
Related Articles
|
|
Jeanne Sager is a freelance writer and photographer living in upstate New York with her husband and daughter, Jillian. She maintains a blog of her award-winning columns at jeannesager.blogspot.com. |
|
|
-
by Tricia Grissom
I chose not to breastfeed.
-
by Kate Tuttle
Is breastfeeding really cheaper than formula? Not always
-
by Madeline Holler
I nursed my daughter until she was almost four.
|
