Information about breastfeeding
Breastfeeding should be baby-led and based on the baby’s signals. This is where the term baby-led breastfeeding comes from. A baby will breastfeed every few hours, sometimes a couple of times per hour. Similarly, the baby’s sleeping patterns will vary from sessions lasting a few dozen minutes to approximately four hours. Within the 24 hour cycle, babies spend around 12–20 hours sleeping. A newborn will not yet be able to differentiate between day and night.
When a baby is breastfed at their own pace, they will get the correct amount of milk needed for their proper development. By supporting baby-led breastfeeding you can support your baby’s self-regulation.
Babies have very small stomachs and will eat varying amounts during a single session the same way as adults have bigger main meals and smaller snacks. A baby will usually breastfeed about 8–12 times a day, but even more frequent feedings are normal. The baby will spend time on the breast from a few minutes up to several hours. The length of a breastfeeding session does not indicate the amount of milk they have received. Everyone has their own individual schedule and length of breastfeeding sessions.
Many people are surprised at how long breastfeeding takes, at least at the beginning. However, breastfeeding is a natural way for a baby to eat. Breastfeeding is easy for mothers. They have the milk with them and available for their baby at the right temperature. In addition, breastmilk contains the right proportions of all the nutrients for the current developmental requirements of a baby. The milk will change in consistency as the baby grows.
Babies indicate that they are hungry by licking and smacking their lips, opening their mouth and sucking on their hands. If a baby’s hunger cues are detected on time, they will have enough time to begin reaching for the breast and latch on properly. When the baby is latched on well, breastfeeding is efficient and will not hurt.
Newborns will instinctively seek their mother’s breast, taking certain steps. This reflex-like behaviour is called the breast crawl. When a baby is helped to the breast and in skin contact, they will begin poking the breast, licking and sucking at the nipple, pressing their hands against their mother’s chest and grasping the breast. This is the baby’s way of preparing the breast for breastfeeding. You should let your baby do this in peace so that they can latch on properly.
Crying is a late hunger cue from a baby. Sometimes it is difficult to help a crying baby to the breast. In these instances, you should first try to calm the baby down by caressing them or swaying them in your arms, so that they can again focus on seeking the breast. The father or a support person can greatly help in achieving this.
Once the baby has reached for the breast and latched on, they will begin expressing milk. They will do this with strong and frequent, even greedy, sucking. Once the milk begins to flow from the breast into the baby’s mouth, the sucking rhythm usually slows down slightly. At this point, you will be able to clearly feel the rhythm of sucking, swallowing and breathing.
At the beginning of a breastfeeding session, the baby will be quickly drinking large quantities of foremilk, which is expressed more easily. Once the foremilk has run out, the baby will again change their sucking rhythm. Usually, when the baby begins drinking the hindmilk, which has a higher fat content, their breathing intervals and pauses in sucking become longer. Often towards the end of a feeding, babies take relatively long breaks in sucking, but they will not yet be ready to release the breast. A satiated and satisfied baby will let go, once they feel ready.
In order for the baby to breastfeed efficiently, they must be properly latched on. You can easily tell that the baby is in the correct position if the breastfeeding does not hurt. Breastfeeding may hurt for the first 30 seconds as lactation begins. After that, there should be no pain.
The correct way for a baby to latch on is to have their mouth wide open, as if biting on a big hamburger. The baby is properly latched on when more of the mother’s areola is visible above the nipple than below it. In the correct position, the baby’s lower jaw is touching the mother’s breast. Often, the baby’s upper and lower lip will be turned outwards. The baby will suck with its jaw. That is why proper sucking motions will look quite unnoticeable. Only the baby’s lower jaw will be moving.
If you see dimpling in your baby’s cheeks (similarly to an adult drinking with a straw), hear sucking sounds or the breastfeeding hurts, you should unlatch the baby and try to get them to latch on again. Being in skin contact before breastfeeding will help your baby latch on.
There are several suitable variations of the breastfeeding position. By trying out different things and practising, you can find the best ones for you and your baby. However, here are some things you should remember.
1. The baby should be able to tilt their head freely back as they latch onto the mother’s breast.
- When reaching for the breast, the baby should have their nose level with the mother’s nipple. When the baby makes contact with the breast in this position, their head will tilt back to allow for proper latching. It can sometimes be difficult for the mother to verify this herself. Her partner or support person can therefore assist her by letting her know when the baby’s head is in a good starting position.
2. When the baby is nursing, their chest should always be facing the mother, i.e. the baby’s head or body should not be turned to either side.
3. The baby should be able to freely move their head.
- The baby must be able to move their head freely in order to latch on properly. This is important so that the baby can unlatch from the breast once they feel satiated. Usually, when you are breastfeeding your baby in your arms, the suitable position is to have the baby’s neck rest against your wrist. Alternatively, you can position the baby to lie on top of your chest while being vertical. When breastfeeding while lying on your side, you can place a pillow or a blanket behind the baby’s back as support.
- When bringing a small baby to your breast, you should not support the back of their head or even touch their head. The baby has a reflex that will make them push their head against the hand behind their head, and this will lead to the baby’s head moving away from the breast rather than towards it and cause the baby to hyperextend their neck.
4. The baby needs to be close to the mother.
- The mother can support the baby’s upper back with a firm grip so that the baby’s head can tilt back and they can latch on with a wider mouth.
- When learning new breastfeeding positions, you should use pillows and other support means to find a relaxed and comfortable position. The most common challenge in establishing a good latch is usually caused by the baby being too far away from the mother and not having their head tilted back far enough. Breastfeeding is a skill that you need to practise together with your baby. Over time, this skill will improve. You can ask for advice and help from the maternity and child health clinic.
If your baby is energetic, wakes up on their own to feed and mostly falls asleep satisfied after breastfeeding, they are likely getting enough milk. Another sign of sufficient nutrition is your baby’s weight gain, which is monitored at the maternity and child health clinic. During the first weeks, your baby should put on at least 20 g a day or 140 g a week.
A good way to monitor at home whether your baby is receiving enough milk is to track the so-called safety signs. If your baby
- urinates at least five times a day (from four days of age onwards)
- passes stools at least once a day (under the age of six weeks)
- breastfeeds efficiently at least eight times a day
they are getting enough milk. If you become concerned for your baby’s well-being or the amount of milk they are getting, you should contact a nurse at the maternity and child health clinic.
It is important for the well-being of the entire family that the spouse also takes part in the feeding and caring for the baby. Research shows that the partner’s support is the most important thing for a mother and has a real effect on the success of breastfeeding. Therefore, spouses should also receive information on how to feed and care for their baby. Read The family guide to breastfeeding (pdf).
Family coaching provides information about breastfeeding. Families can also search for information together online.
It is natural that initially breastfeeding will take up the majority of the mother’s time. Her partner then has a vital role in providing mental support. The partner may also do many concrete things to help the mother.
For example, the partner can
- bathe the baby and change the nappies
- manage the household and take care of the family’s other children
- make sure that the mother is getting enough rest, nourishment and liquids, thus allowing her to concentrate on the breastfeeding
- help the mother during the first few days of breastfeeding if she needs assistance with getting the baby in the correct position
- ensure that visits from family and friends are not too taxing for the mother. Creating a calm environment without potential disturbances to your home makes breastfeeding easier.
Friends and family can show support by bringing food and other supplies to a family with a newborn baby and by offering child sitting help with the family’s other children. A natural connection between a baby and the parents can form if the mother’s partner also participates in caring for the baby.
In single-parent households, the support from friends and family can play a critical role in the success of breastfeeding. Help with everyday life is also available at the maternity and child health clinic. For example, receiving home help has often proven to be a good solution in families with twins.
Many mothers experience tenderness in their nipples when they first start breastfeeding. If breastfeeding is painful or the skin on your nipples cracks, you should let the maternity and child health clinic check that your baby is latching on properly.
- You can treat sore nipples with lotions specifically designed for this purpose. These lotions are available at pharmacies.
- You can squeeze out a drop of milk to protect the nipple.
- Letting your nipples air dry between feedings will soothe them.
- If your nipples are cracked, you should let the maternity and child health clinic check that your baby is latching on properly.
- You can still breastfeed your baby even if your nipples are bleeding.
- If the skin on your nipple is broken, you should not let it scar over and become cracked again the next time you are breastfeeding. You can place a milk collection shell or a gauze moistened with saline or breastmilk over a cracked nipple to keep it hydrated and prevent scarring.
- If you have cracked skin on your breasts, you need to keep your hands clean in order to prevent bacteria from causing an infection there.
- You should wear warm clothes outdoors and protect your breasts against the cold, for example with a warm scarf underneath your coat. You can change into a dry pair of nursing pads before going out.