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    Breastfeeding Techniques

    Breastfeeding is a learned skill for both mother and infant, requiring both time and patience.

    When to Start

    Research shows that the critical days for breastfeeding success are the first six to seven days after delivery, and later near the baby's sixth week. It is important to get the help you need through these times. Fatigue may play a large role in any doubts about continuing breastfeeding. If possible, get help with the household chores and infant care, allowing time for rest and comfort. Do not hesitate to accept help when offered. Simplify the chores as much as possible, such as using paper plates/cups or using a grocery delivery service.

    Breastfeeding after a Cesarean Birth
    A cesarean birth does not directly affect the breastfeeding process. However, discomfort, fatigue, and the medications used in surgery may present more of a challenge when you begin breastfeeding. Nurse your baby as soon after delivery as possible (and on demand every1 to 3 hours per 24 hours, which is 8-12 times per 24 hours). Once you begin regular feedings, your milk supply will increase.

    Your partner or support person will be a valuable asset in assisting you as you lift and position your baby. You may be more comfortable using the football hold, side-lying, or cradle hold while cushioning your abdomen with a pillow.

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    The First Few Weeks of Breastfeeding

    If possible, put your baby to your breast within the first hour after birth. Nurses can teach you ways to help the baby latch on using the best positioning to ensure success. Continue to feed your baby on demand every 1 to 3 hours per 24 hours (8-12 times per 24 hours). Frequent feedings minimize feeding problems and are the best way to prevent breast engorgement.

    Getting Started

    • Create a peaceful "nursing station" and allow yourself to relax.

    • Find a comfortable position, such as in a chair, with ample room on the sides and back for pillows to support your baby and your arms. Make sure your feet are elevated at a comfortable level. Sitting up in bed with pillows under your legs or using a footstool when in a chair will help you be comfortable.

    • Unwrap your baby and check his/her diaper; change it if needed. This will help arouse and stimulate your baby to nurse, especially if your baby is sleepy. If your baby is awake and ready to nurse, wait until after the first breast to change your baby's diapers.

    • It is normal for babies to be sleepy the first 24-48 hours after birth. Attempt to breastfeed every 1 to 3 hours per 24 hours (8 – 12 times per 24 hours).

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    Breastfeeding Positions: Cradle Hold (Tummy to Tummy)

    1. Sit as straight as possible with a pillow behind you, or sit on the edge of the bed.

    2. Cradle your baby in your arm, her tummy against yours and her head resting in the bend of your elbow. Her ear, shoulders and hip should be in a straight line.

    3. Tuck your baby's lower arm out of the way, with her mouth close to your breast.

    4. Support your breast with your free hand; place all of your fingers underneath it, well away from the areola.

    5. Rest your thumb lightly on top of your breast above your areola.

    6. Lift your breast upward and lightly stroke your nipple on your baby's lower lip. As part of the rooting reflex, her mouth will open wide.

    7. Pull her quickly onto the breast to latch-on when her mouth is opened wide, like a big yawn, and her tongue is down. Do not lean over your baby; keep your back straight, and pull your baby up to your breast.

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    Cross Cradle Hold

    Follow the steps for cradle hold except for #2. Instead, cradle your baby with your arm, her tummy against yours and your hand behind her head. Her ear, shoulders and hips should be in a straight line.

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    Football Hold

    1. Position your baby so her legs and body are under your arm, with your hand holding her head (as if you were holding a football).

    2. Place your fingers below your breast. Allow your baby to latch-on while pulling her in close, holding her head tightly against your breast.

    3. Keep your baby's body flexed at the hip with her legs tucked under your arm.
    The football hold is a good position when:
    • You have had a caesarean birth and want to avoid placing your baby against your abdominal incision.

    • You need more visibility in getting your baby to latch-on.

    • Your breasts are large.

    • You are nursing a small baby, especially if premature.

    • Your baby tends to slide down your areola onto your nipple.

    • Your baby is fussy, restless and hard to latch-on.

    • Your baby is sleepy. Sitting upright may encourage her to remain alert for a longer period.

    • You have inverted nipples.

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    Side-lying Position

    Side-lying position

    1. First, position yourself and your baby on your sides tummy-to-tummy.

    2. Bend your top leg and position with pillows.

    3. Place your fingers beneath your breast and lift upward, then pull your baby in close as she latches-on.
    The side-lying position is an especially good choice for breastfeeding when:
    • You must be flat after a caesarean birth with spinal anesthesia.

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    If your baby latches on only to your nipple and not the areola, problems may develop, such as sore nipples and inadequate milk supply for your baby.

    You may have to repeat these steps several times before your baby latches on correctly.

    1. Sit or lie tummy-to-tummy with your baby. Make sure your baby's ear, shoulder and hip are in a straight line.

    2. Bring your baby close to your breast.

    3. Touch your nipple to your baby's lower lip.

    4. When his/her mouth opens wide, quickly pull your baby in to latch on. Since your baby's mouth will be open for only a few seconds, you will need to pull him/her toward your breast quickly. NOTE: Bring your baby to your breast, not your breast to his/her head.

    5. Your baby will be able to breathe even though his/her nose may press against your breast. It is helpful in the first week to continue to support the weight of your breast throughout the nursing session. Support your baby's head at the base of the neck as well.

    6. Look for the following things after your baby is latched on:

    7. Your baby's mouth should surround the tip of your nipple and about one inch of the areola.

    8. The lips should be turned outward against the breast.

    9. The motion of the suck is along the jaw, not in the cheeks.

    10. Baby's ears, shoulder and hip should be in a straight line.

    11. Breastfeeding should not hurt.

    12. You should feel a rhythmic tug on your breast, and a little bit of nipple tenderness is normal during the learning period. However, sore, bleeding or cracked nipples are not normal.
    If you need advice or are having problems, consult a lactation specialist. Call (415) 600-BABY.

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    Taking Baby Off Your Breast & Burping

    Be sure to break the suction by slipping your little finger in the corner of your baby's mouth between her gums. Don't remove your baby from your breast until the suction is released, or sore nipples may result. The suction is usually quite strong and it may require some effort to release her grip.

    Burping Your Baby
    Burp your baby after feeding at each breast and at the end of the feeding. Generally, breastfed babies do not swallow as much air as bottle-fed babies. If your baby has been crying before the feeding, nurse for a short time, then stop and try burping. Some babies do not burp immediately and may need to be put in several positions.

    When burping your baby, remember to apply some gentle but firm pressure on her abdomen. If after five minutes, your baby has not burped, and she seems comfortable, she doesn't need to burp.

    Helpful positions for burping your baby include:

    Propped up with baby's tummy against your shoulder.

    Lying tummy-down across your lap.

    Sitting up, leaning over with your supportive hand under baby's arm.

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