Breastfeeding…Your First Time
by Louise Arce Tellalian

So, it's your first time nursing a baby!  Did you read a comprehensive breastfeeding manual or take a prenatal breastfeeding class?  If not, you may feel insecure about how to begin. Somehow it doesn't feel as natural as you thought.  Here are a few beginning suggestions.

When bringing the baby to the breast for feedings, it is important to have the front surface of the baby's body up against the front surface of your chest and midriff.  The baby should be held snugly to your body and the breast supported from below throughout the feeding. Trying a variety of positions allows you to find the one that is most comfortable. You may sit or lie down for feedings.

Cradle hold
Hold baby at level of breast.  Support her head in bend of your elbow.  Support her torso with your forearm and grasp baby between the legs.  Turn baby on her side so face, belly and knees all are touching your breast/midriff.  Her nose should be opposite the nipple.

Football Hold
Hold infant so her torso and legs are tucked under your arm and supported against your rib cage.  Cradle the baby's head in the palm of your hand and guide towards the nipple. A favored position after Cesarean, with a premature, or anytime head control is an issue. Offers best visibility of baby's face.

Side Lying
Lie on your side.  Place baby on its side so her face is directly looking at breast. Use pillows to maintain your posture.  A recommended position when sitting is uncomfortable due to a Cesarean, an episiotomy or hemorrhoids.  A great way to doze and feed simultaneously.

Whatever position you use, pillows strategically placed under the baby or in support of your arms and back will reduce fatigue or unnecessary muscle strain.

A comfortable attachment (latch on) to the breast involves the following steps:
    1.  Support your breast with your free hand.  Make sure all fingers do not touch the areola (darker area behind the nipple), so baby is free to attach well behind the nipple.
    2.  Lightly tickle the center of the baby's lower lip with your nipple until the baby opens its mouth as wide as a yawn and her tongue is down.  It may take as much as a minute or two before the baby responds until she learns the signal.
    3.  While her mouth is wide open, center the nipple and quickly pull the baby onto the breast so that her nose and chin lightly touch the breast throughout the feeding.
    4.  If the baby attaches only to the nipple or her suckling is painful, place a clean finger between her gums to break the suction and then try again. Look for sucking and swallowing movements.  Swallowing is a good indicator of the baby's actual intake.

From the time of birth, the baby should be fed at least eight times in twenty-four hours and suck and swallow for at least twenty minutes per feed.  This may require waking the baby for feedings.  Avoid the use of any artificial nipples for about three weeks until she learns to breastfeed well.  By day four or five, expect to see at least six to eight wet diapers and one or more loose, golden colored bowel movements per day.

If you have questions or are having difficulties it will be helpful to contact a lactation professional or another experienced nursing mother.  The earlier you ask for help, the better the chance of easy resolution.  In the Los Angeles area you can get a free directory of breastfeeding services by calling The Breastfeeding Task Force of Greater Los Angeles at (818) 856-6650.  Have a good time!  Breastfeeding is supposed to be enjoyable.

Louise Tellalian is a registered nurse, ASPO certified childbirth educator, and a UCLA certified lactation consultant in private practice in Beverly Hills, CA.  She is also an instructor in the UCLA Extension Lactation Consultant and Childbirth Educator Training programs.  Louise has authored several articles and lectures in the areas of childbirth and breastfeeding.