Breastfeeding: the signs that say you’re doing it right

Jane Barry talks about signs to look out for while breastfeeding, so you can feel confident you're getting it right.

 

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Jane Barry has qualifications and expertise in general, paediatric, midwifery and child health nursing. Profile

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In the early days with your newborn, breastfeeding consumes many hours, and mothers are often surprised about just how long each feed may take. Days and nights merge in a somewhat milky haze, leaving little time to do anything else. This is pretty normal and with time and your baby’s increasing maturity, you’ll find their feeds will become more spaced apart.
Breastfeeding can look very easy – after all, isn’t it supposed to be one of the most natural things in the world? Though for something so apparently simple, breastfeeding can create a lot of confusion and doubt. You can find yourself wondering: is my baby attached correctly? Is she sucking as she should be? Is my milk coming down and do I have enough milk for her? These and other nagging worries can erode even the most confident breastfeeding mother.

It’s important to check with your baby’s healthcare professional to ensure your baby is growing as she needs to. Regular visits to your child health nurse, GP and/or your baby’s pediatrician will also be very useful.

You can’t be hungry again!

Newborn babies are designed to feed frequently. They don’t have the stomach capacity to hold more than a few millilitres of milk and this, combined with their fast metabolic rate, means that they need to breastfeed eight to 12 times every 24 hours. It’s easy for mothers to interpret this as a sign that they don’t have sufficient milk and perhaps need to offer top-up feeds of expressed breast milk or formula. But as long as your baby’s weight gain is steady and she is thriving, then there is unlikely to be any need for extra feeds.
Here are some tips which will help you know if you and your baby are doing the right thing when it comes to breastfeeding. Just remember though, every mother and her baby are unique and what’s right for some may not be right for others.
What’s important is that you are happy and your baby is thriving. From this everything else will follow.

Attachment – what do I look for?

1. Your baby has her chin pressed into your breast but her nose is clear.
2. Her lips are flanged out rather than being sucked inwards.
3. Her tongue is lying over her bottom gum. This can be hard to see but you’ll feel nipple pain if her tongue isn’t cushioning her bottom gums.
4. Some of your areola as well as your nipple is in your baby’s mouth.
5. You’re not feeling any pain other than a sensation of nipple “stretching”. This should settle a minute or two into her feed.
6. You’ll see your baby’s jaw moving as she sucks. This can start at the chin and extend right along her jaw up to her ears.
7. If she is sucking effectively, her ears may be wiggling in synchrony with her jaw.
8. Her cheeks aren’t sucked in or hollow looking. This means she has created a good seal around your nipple.
9. She’s not sliding off your nipple but stays firmly attached.
10. She has little pauses and rests between periods of active and strong sucking.
11. You feel that she is sucking correctly by a gentle pulling sensation and can feel this right through your breast.
12. You may see your breast moving as she sucks.
13. You see her sucking and then swallowing – a typical pattern is a few sucks and then a swallow, a few sucks and then another swallow.
14. You may feel a “let down” or milk ejection response. This is like a tingling or painful sensation in the breast or your nipples. You will notice milk dripping or flowing from your other nipple and your baby’s suck may change, becoming stronger with a distinct suck/swallow pattern.
15. Your baby is happy and content to suck. She’s not fussing, pulling away or crying. She seems satisfied and happy.
16. Her sucking may be noisy or just quiet. If she’s really hungry and her stomach empty, you may hear the milk flowing down into her stomach.
17. You see some milk pooling around the corners of her mouth.
18. She pulls off when she is full and is calm and perhaps even sleepy.
19. When she starts sucking her fingers are stretched out and her hands open. These splayed fingers are a sign of the concentration and effort she’s putting into sucking. Towards the end of the feed as she feels fuller you’ll see her hands relax and her fingers resume their natural curved position.
20. Your breasts will feel lighter after your baby has fed. If she has been attached and sucking correctly your breasts will feel different at the end of the feed.

How should I attach her?

Try not to control your baby’s attachment too much. Babies are born with inbuilt reflexes which help them to seek, find and then attach to their mother’s breast. In healthy, full-term babies who are allowed free access to the breast, most will find their own little way to the nipple and start sucking.
Many mothers are comfortable holding their baby for breastfeeds in a traditional “cradle” or “Madonna” hold with their baby’s head supported by the inner aspect of the mother’s elbow and their body in alignment with their mother’s forearm. But again, what works for you is fine.
You may find that a breastfeeding position which worked when your baby was very young may not be as comfortable as she gets older. As she becomes heavier and more mobile you may need to work out some other positions which work for you both.

Other tips for successful attachment

• When considering where to have your baby, look for a maternity hospital which follows the Baby Friendly Hospital Initiative (BFHI). This is a joint collaboration between Unicef and the World Health Organisation (WHO).
• Speak with your midwife and/or doctor about how keen you are to breastfeed. They will do all they can to ensure your baby is placed to your breast as early as possible.
• Offer your baby a breastfeed as soon as possible after birth. If she is too sleepy or not keen it will still be useful just to hold her against your breast.
• Provide skin to skin contact.
• Hold your baby close and give her lots of opportunity to smell you and be physically close.
•  When you are holding your baby, look for the characteristic head bobbing, which means she is looking for the nipple. She may also open her mouth very wide and sweep her little head from side to side, using her rooting reflex and lick the breast – all of these behaviours will help her to locate your nipple.
• Be patient. Breastfeeding is a set of learned skills and it can take weeks and sometimes months for a mother and her baby to get it right.
• Avoid offering your baby a dummy or bottles/teats to suck on. This can lead to nipple confusion and delay the establishment of successful breastfeeding.

Signs of sufficient breast milk intake

•  Most importantly – your baby is thriving and she has a regular weight gain.

Average growth weight for babies:

Birth-3 months	Around 150-200 grams/week
From 3-6 months	Around 100-150 grams/week
From 6-12 months	Around 70-90 grams/week

•  Your baby is wetting at least six or more nappies a day. Her urine should be clear and not concentrated or strong smelling.
• She is having lots of golden yellow, soft poos. Newborn babies who are having sufficient breast milk tend to poo with every nappy change until they are a couple of months old and their gut becomes more used to feeding and digesting. Then the dirty nappies tend to slow down.
• Your baby is tracking along her percentile (growth) curves and either staying on the same lines for her weight, head circumference and length or climbing higher. If she is dropping down on her percentiles then this is an indication that she is not growing and needs to be assessed.

This article was written by Jane Barry, freelance parenting consultant, copywriter and director of www.mybabybaby.com.au.

What are your experiences with breastfeeding?

Read more on Kidspot

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• Getting the help you need when you’re breastfeeding

More related reading

• Top breastfeeding tips from Birth.com.au
• What you need to know about breastfeeding your baby from Birth.com.au
• Local support groups from the Australian Breastfeeding Association

Breastfeeding is best for babies and provides many benefits. Combined breast and bottle feeding in the first weeks of life may reduce the supply of your own breast milk. Always consult your doctor, midwife or health care professional for advice about feeding your baby. This post is part of the Early Life Nutrition story.