Breastfeeding Basics: Nursing Guide for New and Expecting Mothers

To breastfeed or not to breastfeed? That is one of the most important and personal decisions facing expectant and new mothers. If you decide to breastfeed, there are some basics you should know to give you the best possible start and help you continue for at least the recommended six months. This article will cover common problems, tips to deal with them, and ways to make breastfeeding a positive experience.

Whether you are a first time mom or an experienced mom, you can start preparing for breastfeeding in the months leading up to delivery. Expectant mothers should take care while showering and bathing and avoid using drying soaps on their breasts. The nipples and areola become more sensitive and unnecessary dryness may cause irritation and discomfort. Air drying the area afterward is also beneficial to keeping the skin healthy and supple. For an added benefit a mother may wish to begin using a special cream such as Lansinoh on the area. These are the easiest and most simple ways to prepare for breastfeeding before the baby arrives.

Once the baby is born, breastfeeding becomes more instinctual. During the first few days after birth, the breasts produce a thin, yellowish fluid called colostrum or "first milk". This first milk contains many benefits to the baby. It is completely normal for a newborn to lose a small amount of weight in the days following birth. This is not an indication that the baby is not receiving enough nutrition or calories. Weight loss after the first week however should be mentioned to the baby's pediatrician. It is very important to begin nursing the baby as soon as possible following birth. This will stimulate the breasts to produce enough to meet the baby's needs. Sometimes circumstance will not allow for immediate breastfeeding. While it may be disappointing this should not interfere with future breastfeeding. A mother can hand express or use a breast pump until breast feeding is possible.

After three to four days following the birth, the mother's milk typically comes in. This is the whitish milk like fluid that will continue to be produced for as long as the mother chooses to breastfeed. This may cause discomfort called engorgement. Engorgement occurs when the breast produce more milk than the baby needs. The breasts become swollen and tender. Engorgement usually can be treated by hand expressing or pumping small amounts of milk in addition to feeding the baby. It often is corrected within a very short amount of time. Warm compresses can also help ease the discomfort along with warm showers. A tried and true "old wives tale" remedy is to place chilled cabbage leaves on the breasts during engorgement. Engorgement rarely causes serious complications but may result in mastitis. This occurs when a milk duct becomes blocked. The signs are typically redness and extreme soreness around the affected area. A mother may also experience a fever and subsequent infection. She should consult her physician for treatment. This is a rare but serious problem. Most of the time though a mother only experiences slight discomfort when the milk first comes in which dissipates on its own once a more regular feeding pattern is established.

Another common problem that occurs during the beginning of breastfeeding is sore, cracked nipples. This is more common in first time mothers but can also be caused by improper latching on of the baby during feedings. If it is simply a first time mother issue, the nipples will heal with only minor intervention. Lansing or similar creams are invaluable during this time. Air drying and avoiding rough or scratchy fabrics will also help. An improper latch can also be corrected easily. To properly get a baby latched on for a feeding, the mother should hold the baby at breast level with one hand and direct the breast into the baby's mouth with the other. The baby should take the entire nipple and most of the areola into his or her mouth. This may take several tries. If it doesn't feel right it probably isn't. A baby can be "unlatched" by wedging the mother's small finger into the corner of the baby's mother slightly. Some various positions may also ease getting a proper latch. The "football hold", in which the baby is held in one arm perpendicular to the mother's side with the feet towards her back, is the most common. In this position the baby's head is cradled in one hand which makes directing the mouth onto the breast much easier. Another popular hold is the side lying position. This is also an especially helpful way to get some extra rest during the first few months.

By the time a baby is two months old breastfeeding is usually established. At this point a mother's only breastfeeding concerns should be to make sure the baby is eating enough, whether or not to put the baby on a schedule, and what type of bottle to use should supplementing be necessary. These are all minor issues that have to be monitored and decided on no matter how a mother chooses to feed her baby. To make sure a baby is eating enough his or her growth should be charted by a pediatrician. As long as the growth curve is where should be the baby is usually considered to be growing fine. Another way to make sure a baby is eating enough that can be done at home is to monitor how many diapers the baby uses in a day. The average baby should be having six to ten wet diapers each day and the urine should appear pale yellow in color. There are generally two schools of thought on how many bowel movements a breastfed baby should be having. One is that they will have more frequent bowel movements because breast milk is easier to digest. Some mother's and pediatricians will say that many breastfed babies will have a bowel movement after nearly every feeding. The other school of thought is that breastfed babies have much less frequent bowel movements, perhaps as few as one a week. The idea behind this is that breast milk ideally has little waste therefore, there is less waste to rid the body of. Generally speaking as long as the individual baby's frequency does not change drastically, it should be fine. A mother should simply make note of any changes that seem unusual for her baby. Scheduling a baby is also a much debated issue. Some mothers feel more comfortable feeding "on demand" allowing the baby to set the schedule. Other mothers prefer to set the schedule themselves and "train" the baby to follow it. It's a personal decision that each mother should decide based on her needs and her baby's temperament. Supplementing with a bottle is occasionally necessary. Whether the mother chooses to pump breast milk or use formula is less important than what type of bottle she chooses to use. If a bottle is used the mother should take care to chose one with a nipple that supports breastfeeding. These are the bottles with the wide, flat nipples. There will be less risk of nipple confusion when using that type of nipple.

Most mothers will have several months of this easy, carefree breastfeeding time. This is the time when the mother-baby bond is formed. Breastfeeding becomes more routine as the weeks and months pass. This is a good time to experiment with breastfeeding in public if the mother hasn't tried it yet. Breastfeeding in public can be quite easy with the proper preparations. Some mothers prefer to carry the baby in a sling type carrier. With this type of carrier the baby can be completely concealed. This is probably the best method for mothers who feel shy or awkward breastfeeding in front of other people. While in a sling it is impossible for others to tell if the baby is breastfeeding or simply being held. Another easy way to breastfeed in public is to simply throw a blanket or cloth over the mother's shoulder and the baby's head. This will also conceal the breast but may be more obvious to others. Some mothers prefer to just wear clothing that will allow easy access to the breast without exposing anything. There are many lines of clothing specially designed for this but regular clothing also can be made to work. A button down style shirt over a tank or t-shirt is the easiest. The mother needs only to button the lower buttons and lift the under layer to the appropriate level to allow the baby access to the breast. A blanket or other cover up is usually unnecessary with this method. Also during this time of "easy breastfeeding" the mother should decide how long she intends to continue. While six months is recommended many mothers choose to continue until one year or more. Again this is a personal decision that should be based on the mother's needs and on the baby's temperament. should the mother choose to discontinue breastfeeding, the bottle or a cup should be introduced on a more regular basis starting at least a month before the mother wishes to end breastfeeding entirely. This will allow the baby time to adjust.

Should the mother decide to continue beyond the recommended six months, there will be one more issue she will have to face at some point. Teething often begins between six and eight months although that is only the average. It may begin sooner or later. Regardless of when it occurs a mother should prepare for the inevitable crankiness and biting. A breastfeeding baby will act the same as any baby during teething. Their gums may become sore and they may lose interest in feeding. This is not really a big cause for concern for the baby. Their bodies know what they need and a few days of lost appetite will not affect their overall health. It may interfere with normal breastfeeding though. If the mother notices that her baby is not feeding as often and her breast feel more full than normal, she should try to hand express or pump the extra milk to keep her supply at it's normal level. Once a tooth or teeth have broken through the baby most likely will discover biting. While this is a painful consequence it need not be a reason to discontinue breastfeeding. Often babies can be redirected and "taught" to not bite. A firm "No" and removing the baby from the breast temporarily is all that is necessary. After a few times to several days of this redirection the baby usually will learn not to bite down during a feeding. That is not to say there won't be an occasional nibble, particularly when the baby is sleepy, but it should drastically reduce the occurrence.

Some babies will wean themselves, others will continue to breastfeed until they are older or until the mother chooses to wean them.It is commonly recommended to replace the breast with a cup and skip over the bottle entirely when the baby is ready to be weaned. This may save the baby from unnecessary dental problems in the future. When the baby weans itself, it is typically very simple. They begin to lose interest in the breast slowly over time, the mother's supply decreases at the same time. Eventually the baby will not take the breast at all and the mother's supply will dry up on its own with no negative side effects. If a mother wishes to wean the baby, she may chooses to do it slowly which will have the same results as when a baby weans itself, or she may choose to do it suddenly. While this is the quickest method to wean it most likely will cause some discomfort for both the mother and baby. The mother will probably suffer from engorgement for several days to a week during this type of weaning and the baby will probably be unsure as to why he or she is no longer able to breastfeed. That may cause the baby to be cranky, fussy, and/or more clingy than normal. Many mother's recommend having a partner help with the weaning process. The thought is that if the mother is not present during feedings the baby will be more likely to accept the cup or bottle instead. Another growing trend is "extended breastfeeding". This is the continuing of breastfeeding beyond the first year. Many mothers that have chosen this feel that there are no health reasons to discontinue breastfeeding at one year. It is felt that breastfeeding still offers many positive benefits to the baby. There are even some mothers that have continued breastfeeding their children for several years. The length of time a mother breast feeds is yet another personal decision. As long as the baby continues to be healthy the mother should feel confident in whatever she chooses.

Overall, breastfeeding is usually a very positive experience for both the mother and the baby. There are positive health benefits to breastfeeding as well as emotional benefits. Under the right circumstances and with the right preparations most mothers can be successful at breastfeeding for the first six months and beyond. Support groups are available world wide and often nurses and lactation consultants are available at hospitals to answer common questions and concerns. Other mothers are also a great source for support and advice. Breastfeeding can be time consuming and it is a great deal of work at times but the rewards to both mother and baby are also great.