PREGNANCY

2:05 a.m. Stephanie Roe steps awkwardly out of the tub where she had been trying to relax through some very intense contractions. Now she suddenly feels like bearing down, and her husband and midwife quickly dry her off and help her onto the bed.

2:12 a.m. After just three strong pushes, baby Cole is born, weighing six pounds,
15 ounces.

2:20 a.m. Cole is already nursing.

“For about five minutes he just lay on my stomach,” Roe remembers. “Then the cord was cut and I moved him towards my breast. He was like a little shark, moving his head back and forth and searching for the nipple.”

Roe cuddled him close and let him latch on by himself. “He didn’t nurse for long that first time, maybe five minutes or so, then he let go,” she says. “He was very alert and wanted to look around at everything. Then about three hours later, he had a really good nursing and fell asleep.”

Theirs was a smooth beginning to breastfeeding — and Roe is delighted that nine-week-old Cole continues to nurse well. Not every first feeding is this easy or straightforward, but here are some tips to get you over the bumps in the road and get breastfeeding off to a good start.

How Birth Affects Breastfeeding

Lactation consultant Linda J. Smith, who co-authored Impact of Birthing Practices on Breastfeeding, points out that one contributing factor to Cole’s readiness to nurse immediately after birth may have been Roe’s unmedicated labour. “We know that all medication given for pain relief during labour can affect the baby’s ability to breathe, suck and swallow — and those things affect the baby’s ability to breastfeed,” Smith says. “Mechanical interventions such as forceps, vacuum extractions, inductions and Caesarean sections can cause pressure on the baby’s head, and this too can make it more difficult to establish breastfeeding.”

One study found that the average time between birth and going to the breast was 27 minutes for unmedicated babies; when mothers had epidurals in labour, the average time was more than two hours. This correlates with a 2003 study which found that when mothers had epidurals, their babies were less likely to have at least two successful breastfeedings in the first 24 hours and were more likely to be given at least one supplementary bottle during their hospital stay.

Smith adds: “Mothers should be aware of the possibility that their babies may be affected by labour medications and be patient. Give the baby as much skin-to-skin contact as possible. And if the baby is not yet able to nurse, plan to get the milk out of mom and into baby until the baby is ready to nurse.” That may mean hand-expressing — which is more effective with colostrum — and feeding the milk to the baby by cup or syringe. If the mother is feeling up to it, beginning to express milk within the first hour after birth is ideal, both to stimulate her own milk production and to give her newborn the valuable antibodies colostrum contains. When there are complications, though, this might need to wait for a few hours.

Lactation consultant Patricia Keeling, who is in private practice in Owen Sound, Ontario, also emphasizes the importance of skin-to-skin contact. “Being on your abdomen, hearing your voice, inhaling your scent, all these things are important in preparing the baby to nurse,” she says.

Originally published in Today's Parent, Pregnancy & Birth, Spring 2004