Breastfeeding for beginners

Breastfeeding doesn’t always come easily. This surprises many new parents who don’t realize that it is a learned skill for both parent and baby, and that it often takes time, practice and support to get it right.

Learning to breastfeed can feel overwhelming when you are also recovering from childbirth and caring for a newborn. Knowing what to expect before your baby arrives can help reduce some of the stress that many new parents run into when they start breastfeeding.

“For most people, breastfeeding is possible – but that doesn’t mean it’s easy from the start,” says Nicole Jenkins, BSN, RNC-NIC, IBCLC, Lactation Consultant for Neonatal-Perinatal Services at Children's Health℠. “I see lots of new parents get discouraged by early feeding challenges. But it’s important to remember that the goal is a healthy baby and supported parent, and that success looks different for every family.”

Breastfeeding 101

Breastfeeding your baby is a personal choice. Evidence shows that breastfeeding for at least the first six months of life offers both you and your baby numerous benefits, including:

• Ideal nutrition and immune support for babies

• Bonding and soothing

• Convenience and cost savings

• Recovering from childbirth

Breastfeeding positions

When you’re first getting started, it’s easiest to breastfeed in a position that allows you to help control your baby’s neck. There are two positions that are usually best for beginners:

• Cross cradle. Lay your baby on their side across your lap, facing you. If your baby is feeding from your left breast, hold them with your right arm to support their neck and use your left hand to hold the outside of your breast behind the areola to shape and guide the nipple to their mouth. If feeding from the right breast, hold them with your left arm and use your right hand to guide your breast.

• Football hold. Lay your baby on their side under your arm like a football, facing you. If your baby is feeding from your left breast, support their neck with your left arm and use your right hand to hold the inside of your breast behind the areola to guide the nipple to their mouth. If feeding from the right breast, reverse the positions.

In either position, placing pillows to get your baby to the level of the breast and to allow your arms to rest and support your baby’s weight will help support their weight. Depending on the size of your breasts, pillows can also help to correctly position your baby at the nipple.

It’s normal for these positions to feel awkward at first, but it will get easier with time and practice.

(usually 2-3 weeks before you start to feel skilled) Once you and your baby have established a breastfeeding relationship, you can explore other positions you may prefer. Babies get hungry anytime and anyplace, so you’ll likely find that creativity and flexibility are part of breastfeeding.

Signs of a good latch

Breastfeeding is not supposed to hurt. If your baby is latching correctly, you should not feel any discomfort beyond perhaps the first initial grab. Signs of a good latch include:

• Most of the areola (the area around the nipple) is in your baby’s mouth (depending on the size of your areola)

• Feeding should feel like a firm tug

• You hear and see your baby swallowing

• After feeding, your nipple should look about the same as it did before nursing (not pinched, flattened, bruised or shaped like a lipstick tip)

If breastfeeding is causing pain or discomfort, try to encourage your baby to take more of the breast in their mouth or break the latch and try again. If you have trouble positioning your baby on your own, ask someone to help.

What to expect in the first few days

Skin-to-skin contact happens as soon as possible after birth. When placed on your chest, most babies will instinctively try to find the breast. With a little guidance, even babies who are just a few minutes old can successfully latch and feed. Establishing a good latch is one of the most important parts of these first few feedings.

How often should I breastfeed?

For the first few weeks, newborns should be allowed to feed at any time, day or night. Always offer your baby both sides of your chest, alternating which breast you offer first with each feeding. Your baby should be getting enough to eat if they are:

• Waking up every two to three hours to eat

• Spending a total of around 30 minutes eating during each feeding

• In the first week, producing the number of dirty diapers that correspond to their age (i.e., three dirty diapers a day when they are three days old), plus several more wet diapers

• After the first week, producing at least six dirty diapers a day, plus more wet diapers for the first month

Some newborns are sleepier than others, so your baby may occasionally need some gentle encouragement to wake up to feed or to stay awake at the breast. But typically, newborns shouldn’t be going longer than four hours without feeding.

Colostrum and meconium

For the first couple of days after birth, your body will produce colostrum, a condensed introduction to breastmilk that is packed with everything your baby needs. Your baby’s stomach is very small at this time, so they only need about a teaspoon of colostrum per feeding.

During this time, your baby’s dirty diapers will have a dark sticky stool called meconium. As your breastmilk volume increases, this stool will become lighter, seedier and more yellow.

Engorgement

Sometime within the first week, your breasts will become extremely hard and full. Engorgement is a naturally occurring early phase of breastfeeding that everyone goes through.

Your breasts may not soften after feeding and your baby might have some trouble latching during this time. Don’t be discouraged – this is normal and will pass, usually within 24 to 36 hours. Putting ice packs on your breasts after feeding or pumping can help with discomfort.

Common breastfeeding challenges

Just as every baby is unique, every breast is different. That’s why what works for some people doesn’t always work for others. Some of the most common breastfeeding issues include:

• Sore and cracked nipples. The sensitive skin may get irritated but bruising, severe scabbing, open sores or pain are signs of incorrect latching.

• Sleep deprivation. The first few months of feeding and caring for a newborn around the clock are exhausting. Allow willing and trusted friends and family to support your mental health by giving you windows of uninterrupted sleep or helping in other ways that you are comfortable with.

• Low milk supply. Many new parents worry that they’re not producing enough milk if they don’t have a freezer full of extra breastmilk. But really, you just need enough to meet your baby’s daily needs. It is also normal for your baby’s feeding patterns and your milk supply to fluctuate, so try not to worry if your supply seems to dip from time to time. If you're concerned about your milk supply or your baby's weight gain, don't hesitate to ask for support. Your pediatrician or a lactation consultant can help identify any issues and discuss feeding options.

• Cluster feeding. Babies sometimes go through periods when they want to breastfeed more often than usual, especially during growth spurts, illness, travel or other changes. While cluster feeding is normal, it can be tiring and may make parents wonder if something is wrong. In the early months, flexibility is key, and frequent feeding usually helps your body respond to your baby’s changing needs.

• Tongue-tie. Some babies are born with a tighter or shorter band of tissue under their tongues that limits the movement of their tongue. In some cases, this can affect their ability to latch. But it’s important to know that not every baby who has trouble latching is tongue-tied and not every baby with a tongue-tie needs to have it medically corrected.

If you experience any of these issues, try to be patient with yourself and your baby but don’t hesitate to ask your child’s pediatrician, a lactation consultant or experienced friends for help. Getting help early can prevent pain, stress and feeding complications.

If breastfeeding continues to be a challenge, talk to your doctor about options and resources. Some families exclusively breastfeed, while others combine breastfeeding and formula. There are many ways to keep your baby healthy, happy and growing strong.

When to call a pediatrician

It’s common for newborns to sleep most of the time during their first few days and even weeks. But as they “wake up” to the world around them, most babies become fussier, even if their needs have been met.

Most of the time they’re just tired or gassy and will not need to see a doctor. But contact your pediatrician if your baby:

• Is not gaining weight, not eating frequently enough or having trouble with breastfeeding

• Is fussing so frequently and for so long that it is interfering with feeding and sleeping

• Is regularly spitting up forcefully

• Has a dry mouth or their skin is looking yellowish

• Is not having frequent wet and dirty diapers

Resources to support breastfeeding

• The Mothers Milk Bank of North Texas offers resources and a support group for breastfeeding parents each month.

• Texas Women Infant Children (WIC) offers resources and programming over the phone, online and at various locations across Texas.

• Prenatal breastfeeding classes at hospitals and birth centers can help you learn about breastfeeding early on and help set you up for success.

• Find a new parent support group in your community or on social media.

• Private lactation consultants can usually be found with a quick internet search. Many of them take insurance or have sliding scale payments.

Learn more

Looking for more guidance during your newborn journey? Explore more newborn care resources, expert tips and parenting guidance at childrens.com/newborn where you can find expert-backed resources on feeding, sleep, development and caring for your baby.

Our Pediatric Milk Lab is part of a comprehensive feeding support program that includes inpatient lactation consultants, as well as registered dietitians and speech therapists at many of our outpatient clinics—all dedicated to supporting your baby's growth, health and well-being.

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