Breastfeeding Your New Baby

The vast majority of women are physically able to breastfeed their babies. The World Health Organisation recommends exclusive breastfeeding for babies to 6 months of age, and after this, breastfeeding to continue with appropriate family foods for up to 2 years and beyond (WHO 2011).

The National Health and Medical Research Council (NHMRC) recommends exclusive breastfeeding for around 6 months and after this, for breastfeeding to continue with appropriate family foods until 12 months of age and beyond.

Breastfeeding Self-Attachment

Ideally, babies are able to experience skin-to-skin contact with their mother, immediately after the birth. Skin-to-skin contact is very helpful in stimulating the behavioural reflexes in your baby which promote their ability to independently latch on to the breast. When the baby is able to self-attach using these reflexive behaviours, they will learn how to hold their tongue and mouth in order to effectively milk the breast (Widstrom et al. 1990). If you and your baby are not able to get skin-to-skin after the birth, don’t worry, your baby will have these feeding reflexes for some time after the birth. Your midwife will show you a tried and tested method for helping your baby latch on to your breast. If you experience attachment problems, getting skin-to-skin with your baby later on may enable your baby to resolve the difficulties by using their feeding reflexes.

Colostrum is the perfect first food

At the very start, your baby will barely be able to stay awake long enough to feed. Initially, it can take 45 to 60 minutes to complete a feed. In the first 72 hours or so before your milk comes in, your baby will drink the small amounts of colostrum which are available. These small amounts are exactly what a newborn baby needs, because their tummies can only hold 5 mls of milk! Colostrum is both a perfect first food and medicine. It combines balanced nutrition, with antibodies from the mother which give the baby passive immunities to everything you are immune to.

Babies are born to suck

Newborn babies are born to suck, it’s a reflex. This fabulous reflex is designed to get your milk supply started. Breastfeeding is all about supply and demand. The more your baby sucks at the nipple, the more signals your brain receives to produce milk. When your brain receives these signals, it releases prolactin which stimulates tissues in your breast to produce milk, and oxytocin which triggers the 'let-down' reflex in the tissues of the breast. The 'let-down' reflex happens when the tissues producing breastmilk contract and milk moves down the ducts to sit behind the areola. If your baby does not suck strongly at birth or they are unable to remove the colostrum from your breast, your brain will receive a weaker signal to release these hormones. This can delay your milk coming in and / or negatively impact your milk supply. You might consider using a breast pump as a substitute for your baby’s sucking in this situation. Good attachment and frequent feeding are key to establishing a good milk supply and keeping your baby’s tiny tummy full.

Tips for early success

• If possible wait for your baby to attach themselves to the breast after the birth.
• Avoid introducing anything other than a nipple into your baby's mouth in order to eliminate the possibility of nipple confusion. This includes the use of bottle teats, dummys and nipple shields. If for whatever reason you need to feed your baby expressed breastmilk, this can be achieved using a specifically designed cup or a syringe. If you experience sore or cracked nipples, improving your attachment technique and your baby's latch will allow your nipple to heal even whilst continuing to feed.
• Avoid anything that will interfere with baby’s sense of smell in the first 72 hours e.g. showering, deodorants and perfumes. After the sense of touch, your new baby's sense of smell is the most well developed. This sense is key to establishing breastfeeding. Newborn babies prefer their mother's unwashed breast to her washed breast. The smell of the amniotic fluid that the baby leaves on your chest and the smell of your milk, provide signposts to your baby for future feeds (Varendi et al. 1994).
• Rest as much as possible in the early days, as fatigue can affect your production of milk.
• Drink to thirst and eat to appetite.
• Good attachment is the key to establishing breastfeeding. During the first 72 hrs, you may experience nipple sensitivity. After this time, breastfeeding should be 100% comfortable. If problems arise, seek support AS SOON AS POSSIBLE.

Who can provide support?

Public Hospital Lactation Clinics

Your local public hospital runs lactation clinics for new mums. At the clinic, a lactation consultant will watch you and your baby throughout a couple of feeds and help you to identify and address issues.

The Australian Breastfeeding Association

The Australian Breastfeeding Association runs local support groups. Each group is convened by a trained breastfeeding counsellor who can provide assistance with straightforward breastfeeding issues. The association's website provides full details of your local group and the 24 hour breastfeeding support helpline.

Independent Lactation Consultants

Independent Lactation Consultants are qualified health professionals able to visit you in your own home to provide advice and support with breastfeeding issues. Details can be found here at the Lactation Consultants of Australia and New Zealand Ltd. website.

References

• Cox (2009) Baby Magic: Planning for a lifetime of love, Australian Breastfeeding Association, Victoria: p23.
• National Health and Medical Research Council 2012, Infant Feeding Guidelines, Canberra: National Health and Medical Research Council link
  
• Varendi, Porter, Winberg (1994) Does the newborn baby find the nipple by smell? Lancet 344(8928): 989-990. link
  
• Widstrom, Wahlberg, Matthiesen (1990) Short-term effects of early suckling and touch of the nipple on maternal behaviour. Early Human Development 21(3): 153-63 link
  
• World Health Organization statement 2011, Exclusive breastfeeding for six months best for babies everywhere, Geneva: World Health Organization. link