In the early days, frequent nursing (every two to three hours) establishes good milk supply, but that might not be his schedule – he may nurse three or four times in three hours, then sleep for four hours. Respond to his cues and your milk supply will adjust to meet his needs.
Some babies nurse five minutes at each breast and are satisfied, and some will nurse 20 minutes on each side. Your little one will set the pace. Nurse on the first side until he lets go or falls asleep. Then burp him or change his diaper, and offer the second breast until he lets go or falls asleep again. If your breasts are uncomfortably full, switch sides after a few minutes so he can nurse from each breast. If he’s too drowsy, try undressing him or rubbing his bare feet – skin-to-skin contact with you may stimulate him to keep eating.
Cross-cradle hold: Start with your right breast. Lay the baby on his side along your left arm (so that you’re tummy to tummy) with your hand supporting the back of his neck and shoulders. Your arm should support the baby’s weight and tuck his legs against your body. He should be able to tip his head back. Use your right hand to support your breast. This position works well for premature or small babies, but can be awkward with bigger babies.
Cradle hold: Hold your baby with his neck and shoulders on your forearm (near the crook of your elbow) and your hand supporting his bottom or legs. He should be able to tip his head back and should be lying on his side. Tuck his bottom arm around your waist. You might want to use a pillow or two under your arm to support the baby at the level of your breast, but be careful not to lift him too high.
If neither of these positions works for you, ask your nurses or midwife for help learning the football hold or side-lying position.
Getting a good latch can be tricky and take some patience, but is so important. A nursing baby has to take all of the nipple and part of the breast into his mouth, so the nipple is at the very back, near his throat. To do that effectively, his mouth has to be open very wide with his tongue down and forward, so that it lies under the nipple.
Fast, short sucks without any pauses usually mean the baby is still trying to get the milk to let down, or that the latch isn’t quite right. If he’s opening and closing his mouth fairly slowly as he sucks, with pauses to open wide, it means he probably just got a mouthful of milk. Success!
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Sucking on bottles (or pacifiers) requires a different technique from nursing, and some babies find it confusing to switch from one to the other. If you want to give your baby an occasional bottle, it’s better to wait until he’s at least six weeks old and nursing well.
Some moms find breastfeeding easy and rewarding right from the start, but it’s not the same for everyone. Help is available from certified lactation consultants (find a local La Leche League group), public health nurses, breastfeeding clinics or your healthcare provider. Eventually, your baby’s patterns will become more predictable, and latching and positioning will become more automatic for both of you.
Steps to a perfect latch
1. Support your breast with one hand, keeping a finger or your thumb on top and your other fingers back from the nipple. With your baby in a secure, comfy position, aim your nipple at his nose.
2. The curve of your breast will rub against the baby’s mouth. Wait for him to open wide.
3. As he takes in the breast, use your finger or thumb to help tuck the nipple under his top lip and jaw so he gets a large mouthful of breast, with the nipple at the back of his mouth.
4. As he latches, pull him in close. His head should be tipped back, with his chin buried in your breast and his nose clear. More of your breast is covered by his bottom lip and jaw than by his top lip and jaw.
A version of this article appeared in our Fall/Winter 2013 Newborn baby book with the headline “Breastfeeding Basics,” pp. 32-3.