Preparation of the breasts for breastfeeding should begin during your pregnancy. Avoid using soaps, creams, lotions, and ointments on your nipples unless you have a problem and your clinician advices or prescribes something specifically for you.

If breasts become too full or mother has to be away for a feeding or two, the breast milk may be easily expressed by hand or with the aid of a device called breast pump.

ESSENTIALS OF SUCCESSFUL BREASTFEEDING

Milk supply is increased by frequent nursings. The more you nurse, the more milk you will make.

Short, frequent nursings are most successful in establishing lactation and in preventing sore nipples and engorgement. You should nurse 10 to 12 times per day for the first few days.

It is okay to nurse a baby when he/she cries. You can't spoil a newborn. Rigid schedules don't go with nursing.

Supplements (formula or sugar water) interfere with the establishment of lactation and should not be used in the first days of live.

You can nurse discreetly. You do not need to undress to nurse.

Nipples should be checked at the beginning of the 3rd trimester to be sure they are properly everted. Flat or inverted nipples should be treated during the 3rd trimester to assure easy establishment of nursing after delivery.

BASIC NIPPLE CARE

During Pregnancy

Do not use soap on nipples or areola.

If skin is dry, use a light cream or ointment.

Nipple exercises have not been shown to prevent soreness, but they can help a great deal with inverted or flat nipples. They are also useful in getting women comfortable with handling their breasts.

After Delivery

Begin with short/frequent nursings from birth. Try to nurse 10 to 12 times per day. For the first few days, nursings should be no less than 5 minutes and no more than 10 minutes on each side.

Air dry nipples for 10 to 15 minutes after nursing, before closing bra flaps. In the hospital you may want to use the adjustable lamp over your bed to help in drying. (DO NOT use a sun lamp on breasts.)

A light ointment or oil such as Fougera's Vitamin A & D ointment (with no lanolin) or vitamin E oil (for oral consumption) may be applied if nipples are dry.

Wear bra pads of soft absorbent material with no plastic liner. Change when these become damp.

Be sure baby is well-positioned on the breast. Head should be turned toward the breast and mouth should be well up on the areola. If baby sucks only on the tip of the nipple, you will get very sore.

Always break suction by inserting you finger in the side of the baby's mouth before removing the baby from the breast.

If Nipples Become Sore

At first signs of soreness, begin alternating between the madonna hold and the football hold. If soreness is severe, add upside-down (baby's feet toward your head), lying down position.

Double check the baby's position on the areola.

Nurse often to prevent an overly hungry baby.

Continue to air dry nipples. Additionally, leave bra flaps down to allow air to circulate as much as possible.

Use warm towels or breast massage to help bring milk down to the front of breasts prior to nursing.

Do not nurse through a shield. This only makes things worse.

Apply a thin layer of vitamin E after air drying nipples. The best source of vitamin E for this purpose is a 100 IU capsule which you can poke with a clean pin and squeeze to get the oil out.

Nurse on the least sore side first.

If nipples crack, blood will not hurt the baby. Stools may be dark or baby may spit up more than usual with some blood in the spit-up. This is no cause for alarm.

Hobbit Shield for Sore Nipples can be helpful if bra-flaps can't be left down. Do not use Swedish milk cups.

If soreness becomes severe, contact your local La Leche League leader for personalized advice and moral support.

GETTING STARTED IN THE HOSPITAL

If possible, you should attempt to nurse baby shortly after delivery. It is often helpful to wait 15 or 20 minutes before trying. This allows the baby time to acclimate to the "outside world".

Make it clear to the nursery staff that you want your baby as soon as possible.

Ask your pediatrician to prescribe "NO WATER". If he/she insists on water, ask that it be plain water, not glucose water. Certain medical conditions may require glucose water. Ask your pediatrician to explain the reason if he/she insists on glucose water.

Ask that your baby be on "demand feeding" throughout the night, unless you are excessively tired.

Keep your baby in the room with you as much as possible.

Find out what the schedule is for times when your baby must be in the nursery (eg: some hospitals bring all babies back to the nursery during visiting hours). Plan how you will work in the required feedings, given this schedule.

Take along a nursing gown (preferably short-sleeved, as hospitals are usually warm) and nursing bra.

If baby is sleepy, unwrap him/her, hold, bounce, pat and talk to him/her. Do not let a reluctant nurser spend all his/her time sleeping. Stimulation helps to make baby more alert and willing to nurse.

 

WHEN YOU GO HOME

Expect daily fussy periods - usually in late afternoon or evening. It is okay to nurse as often as you wish during these periods.

Be prepared for 10-day-itis. You are not losing your milk. Baby is just "waking-up" to the world. Bottle-fed babies do the same thing. It will usually last for a few days. (This may coincide with a loss of fullness in the breast. The two events are unrelated.)

Don't over do it physically or emotionally. Rest is essential for the successful establishment of nursing. Take a nap or two each day.

"Cleaning and scrubbing can wait 'til tomorrow, for babies grow-up, we've learned to our sorrow.  So, quiet down cobwebs, dust go to sleep. I'm rocking my baby, 'cause babies don't keep."

Expect growth spurts with a few days of frequent nursing at 4 to 6 weeks and at 3 to 4 months.

If, at anytime during the months you are nursing, you feel like you have the flu, contact your doctor at once. It's may well be a breast infection. You should continue to nurse and increase the frequency of nursing as much as possible. Your doctor will probably prescribe an antibiotic. Take it for the full time prescribed.

Drink to thirst. Do not over-consume liquids. Try to always have a glass of water next to you when you begin to nurse. The letdown reflex is usually accompanied by a strong thirst.

6 or more wet diapers per day indicate baby is getting enough to eat.

Remember, newborns can't be spoiled. Relax and enjoy your baby.