First days of breastfeeding

With a few exceptions, every mother is prepared to produce enough milk of the highest quality, provided she receives the right help and advice. For this reason, you should not be blindly guided by the recommendations of family members or people close to you, but should consult your pediatrician, nurse or other health personnel in search of accurate and up-to-date information.

Correct positioning of the baby, facilitating a good latch-on to the breast immediately after birth, even if the baby does not yet obtain colostrum, stimulates the secretion of the hormone prolactin, which is responsible for activating the production and secretion of breast milk.

Most breastfeeding disorders-breast pain and cracking, mastitis, etc.-are caused by problems with improper positioning of the baby, improper latch-on, or a combination of both.

How to position the baby at the breast?

• Prepare a place where the mother can adopt a comfortable position, since feedings should be prolonged, especially in the first weeks.
• There are different positions - sitting, lying down, the baby in piggyback position, etc. - these should be adopted depending on the conditions of the place and the mother's preferences.
• The mother's position should meet the following requirements:

• The back should be straight.

• Relaxed shoulders.

• Freedom to place the baby in the correct position without having to change her posture.
• Position the baby in such a way that the body and head are aligned, "navel to navel" with the mother; the baby's face should be directed towards the mother's breast, from where he can see his mother's face; the nose should be right in front of the nipple, so that he does not have to shrink or stretch his neck to reach it.
• The mother should hold the breast with her hand in a C-shape and rub the nipple against the baby's upper lip until the baby's mouth is fully open, so that he can get a good latch that includes a good part of the nipple and not just the nipple.
• The mother should not feel pain; she should only perceive the movements of the tongue and lower jaw, she should also observe that a large part of the areola -especially the lower one- is inside the mouth and that the baby's lips are facing outwards and not "tucked in".
• If the mother feels pain or notices that the baby is not latched on properly, she should gently separate the baby and try again until she succeeds.
• The baby should not be removed from the breast, trying to control the amount of the feeding; the baby should be expected to withdraw voluntarily.

• When the first breast is completely emptied, move on to the other breast; the next feeding should always begin with the last one sucked in order to remove any residue that may have remained from the previous feeding.

How to proceed when the baby falls asleep or lets go of the breast?

The mother can put the baby on her or the father's shoulder for two or three minutes and gently massage the baby's back to expel the air that was swallowed during the feeding; then if there is still milk left on the first breast, put the baby on the second breast to continue the feeding; if not, transfer the baby to the other breast; the baby will continue to suckle if he still wants to do so.

Most frequent difficulties during breastfeeding

Drowsy newborns: Some healthy babies during the first few days appear sleepy, take a long time - three hours or more - to claim feedings and are unable to empty the breasts; resulting in inadequate feeding which if not corrected in time can lead to complications such as dehydration, hypoglycemia and jaundice. On the other hand, it could lead to a drastic reduction in breast milk production.

To manage this disorder, the mother should remain in skin-to-skin contact with the baby for a longer period of time and gently stimulate the soles of the feet to wake the baby up. Parents should recognize the early signs of hunger in the newborn - awakening, mild agitation, seeking reflex - and not wait for the cry to offer the breast. They should also watch closely for proper latch-on during feeding to correct possible errors and should not use pacifiers or offer bottles with water or other liquids.

Weight loss: All newborns experience weight loss during the first two or three days of life, which should begin to recover around the third day and should be fully restored between the seventh and tenth day of birth. Therefore, if the newborn does not experience a weight gain by the fifth day of birth, the pediatrician should be consulted as soon as possible.

Pain in the breasts due to swelling (engorgement): If the baby drinks less milk than the mother produces -especially during the first weeks-, it is common for the mother's breasts to feel swollen, hot and painful.

To alleviate this condition, the mother should apply a cloth or bag with warm water on the breasts before feedings, which softens the aureole and facilitates the exit of milk. She should let the baby suckle as much as he/she wants and if there is still milk left, express it manually or with a breast pump.

Nipple cracks: Painful cracks may occur in the nipple due to poor latch-on, improper pumping or excessive nipple washing. The mother does not need to wash her breasts before or after breastfeeding, washing should only be done during the daily bath.

To prevent cracks, the most important thing is for the baby to latch on correctly, covering a large part of the areola. The mother should not use remedies or ointments to cure cracks, except those prescribed by the doctor.

Mastitis: It is an inflammation of the mammary lobules with or without infection. Mastitis can produce pain; red, swollen or hot breasts; fever, chills, headache, nausea, etc. Mastitis can be caused by milk retention or by local factors that cause bacterial overpopulation. It is recommended that the mother seek medical attention for her symptoms.

Milk insufficiency (hypogalactia): In general, all mothers produce enough milk to adequately feed their babies. However, it is possible that the baby is not able to empty the breasts properly because he/she does not adopt the correct position when suckling and this causes a decrease in production.

To increase milk production, it is recommended to breastfeed on demand -including at night-, to correct possible breast latching errors and to leave the baby in skin-to-skin contact with the mother for a longer period of time.

Sometimes the mother produces enough milk, but the breasts look empty because there is an adequate balance between the baby's needs and the mother's production. If the baby is in good general condition, remains calm, grows adequately and wets 4 to 5 diapers daily, he/she is getting enough milk.

Colic in infants: Colic causes intense crying that can last for more than an hour; it usually disappears after babies are three months old. The causes may be various, such as intestinal immaturity or intolerance to milk protein.

When the baby has colic, it is recommended that feedings occur more frequently and while the baby cries, he/she should be held with the head resting on the mother's or father's shoulder while the baby's back is massaged.