The beginner's guide to breastfeeding

Everyone from your midwife to your mum has told you that breast is best. It’s what your boobs are designed for, so surely it’s just a case of popping your newborn on and going with the, er, flow.

Unfortunately this isn’t strictly true – but it’s precisely this expectation that makes new mums give up when they run into difficulties. If you’ve decided to breastfeed, our guide will show you exactly what to do, how to give yourself the best chance of succeeding and where to get help and support if you need it.

The science bit

Stay awake at the back, please! We’re talking about your amazing boobs and how they produce nourishment that’s so good for your baby, it’s even endorsed by the World Health Organisation (which recommends you breastfeed your baby for at least the first six months of its life).

Your breast milk is uniquely tailored to your baby and changes from day to day to meet his needs. It contains antibodies and nutrients that benefit your baby from birth and right through childhood. Even just one day of breastfeeding stabilises your newborn’s blood sugars, protects his gut and provides natural protection against disease.

The production of milk happens through a purely instinctive partnership between you and your baby. As he cries or sucks your nipple, nerve endings transmit messages to your brain to release the milk-stimulating hormone prolactin, and oxytocin, which activates the ‘let-down’ reflex (where the muscles around the milk glands contract, forcing the milk towards your nipple).

In other words, when your baby needs milk, your body will produce it. Magic! But now for the potentially tricky part, getting the milk from your nipple to your baby’s mouth…

Did you know?

*The milk you produce in the first days after the birth is called colostrum. It contains sugar and protein for energy, and antibodies and hormones that stimulate your baby’s digestion.

*Breast milk is composed of water, fat, fatty acids, protein, leucocytes (protective white blood cells), lactose, vitamins and minerals, in the exact amounts your baby needs for his growth and development. Clever isn’t it?

*Your breast milk is a living substance that changes according to the time of day you are feeding and your baby’s age, and its flow alters throughout each feed.

*Your baby gets 90 per cent of his milk in the first ten minutes of a feed. He’ll start by gulping large mouthfuls of fore milk, then settle into a slower sucking motion to feed on the fattier hind milk.

*Did you know? Fore milk is low in fat and high in lactose, sugar, protein, vitamins, minerals and water, whereas hind milk will give your baby essential calories and complete the feed.

Getting attached

A newborn placed on his mum’s chest soon after birth will instinctively ‘root’ to find the nipple and start to suck. However, it’s not just a case of aiming him in the right direction and hoping for the best. He’s as new to this game as you are, and may need a little help to ‘latch on’ properly.

This is key to successful breastfeeding as your milk will flow freely and your baby won’t need to pull at your nipple, which can cause soreness or cracking.

‘Your nipple should be the same shape when it comes out of your baby’s mouth as when it went in,’ says lactation expert Katie Fisher. ‘If your nipple is compressed, white or misshapen when it comes out of your baby’s mouth, get your baby’s latch assessed by your health visitor.’

First days

One day, you’ll think nothing of feeding your baby anywhere from a train carriage to a café (and love the fact you can feed and soothe your little one so easily, any time and anywhere). But in the early day, when you’re just getting breastfeeding established, it’s important that both you and your baby are calm and relaxed.

Feed your baby on demand for the first few weeks as this will encourage your milk flow.

‘Accept all offers of practical help so you can spend time getting breastfeeding established,’ says Katie. ‘Set yourself small, achievable goals, tell yourself you’ll try to breastfeed for the first few days, then for two weeks and so on.

Before you know it, it’ll become second nature and you’ll have got to six months. It’s important to accept that breastfeeding is not easy for all mums and babies, and that you will have good and bad days.’

Finding support

When breastfeeding goes well, it’s so much more than simply giving your baby the best nutritional start in life. Breastfeeding releases hormones that make you feel good and the sucking motion releases tension in your baby.

The intimacy of holding your baby close is soothing for both of you and each feed builds the bond between you. As their babies grow and thrive on their breast milk, many mums feel a sense of achievement and pride that they are nurturing their babies.

On the other hand, if your baby isn’t feeding properly, or breastfeeding is painful for you, it can be hell. There’s nothing quite so frustrating, upsetting and confidence-sapping as being unable to feed your own crying baby. But it’s common to have problems – so much so that there is a huge network of free and expert support out there for new mums to tap into.

‘Read as much as you can about breastfeeding before your baby is born, attend a breastfeeding class or workshop, and find out where your local source of specialist breastfeeding help is,’ says Katie.

Often, you can feel most alone at 3am when you have a distressed baby on your hands who refuses to be comforted at the breast. But knowing you have someone to talk to who understands what you’re going through can go a long way to restoring your confidence. 

Engorgement and other potential pitfalls

You’re not the only new mum who has found breastfeeding a challenge – it’s a skill both you and your baby need to learn together. If you do experience problems, most of them can be resolved with the right approach. In most cases, you should keep feeding your baby.

Let-down pain

(Pain in your boobs at the start of a feed is caused by the muscles in the walls of your milk ducts contracting to push milk to your nipple). This pain usually disappears after the first few days of breastfeeding. Ensuring your baby is latched on correctly will help.

Engorgement

If your breasts aren’t drained of milk completely, they will become swollen and painful. It’s important to keep feeding, as you need to empty your breasts. Make sure your baby is latched on properly and is getting enough milk at each feed.

Chilled cabbage leaves

put on your breasts for 20 minutes every four hours may sound bonkers, but they’re cooling and can help draw out excess fluid.

Cracked nipples

If your baby is only sucking on your nipple, rather than taking the whole areola into his mouth, the pressure will cause your nipples to become sore and cracked. Although it’s painful, try to keep feeding your baby to avoid engorgement. Soothe cracks by rubbing expressed milk onto nipples after a feed and allowing it to dry naturally.

Blocked milk duct

This will cause a hard, painful lump in your breast. Check your baby is latching on properly and feed more frequently if you can in order to drain the blockage. Use a different position at each feed to drain the affected area.

Blocked ducts can sometimes lead to mastitis, which will cause swelling and redness in your breast and a slight temperature. In severe cases, this may need treatment with antibiotics. 

Getting started

Discovering what suits you and your baby will take time and patience but it’ll be worth it! Our step-by-step guide will show you exactly how to get started in the traditional breastfeeding position.

1. Sit in a comfortable chair with your back straight and your lap flat. Bring your baby to your breast, rather than leaning over to give your breast to him.

2. Hold your baby so his tummy is facing yours, his face is at one breast and his feet at the other. You can use pillows to bring him to breast level. Use your arm to support his back, with his bottom under your elbow, and your hand to support his neck. Don’t restrict his head.

3. Your other hand (the one on the same side as the breast you’re feeding from) can be positioned in a ‘C’ and cupping your breast. (Once your baby is feeding, rest his head in the crook of this arm).

4. Position your baby’s head so his nose is opposite your nipple and allow his head to tilt back slightly. Stroke his cheek or move his mouth gently across your nipple until he opens his mouth wide.

5. Bring him towards your nipple, ensuring his bottom lip and chin touch your breast first. When he’s latched on properly, his chin should be pressing against your breast, and his nose should be free, allowing him to breathe properly. He should have most of your areola (the dark area around your nipple) in his mouth and your nipple should be touching the roof of his mouth.

6. If he only takes your nipple, and you can hear a clicking sound, he’s not latched on properly. Put your little finger into the corner of his mouth to break the suction, take him off your breast and try again. In the early days you might feel pain for the first few seconds as his gums ‘clamp’ onto your nipple, but after a week or two you won’t notice it any more.

7. He’s likely to suck quickly at first, before relaxing into a slower rhythm – you’ll know he’s feeding correctly if you hear a soft swallowing sound and you can see his ears wiggling.

8. Aim to feed for at least 20 minutes to ensure your baby gets both the fore milk (the watery, thirst-quenching stuff) and hind milk (the rich, creamy milk). Some babies may feed for up to 40 minutes. If your baby is latched on properly and feeding well, he’ll come off the breast himself when he’s had enough.

Where to get help

Your midwife or health visitor can offer advice and support when you are establishing breastfeeding and if you are having problems

Association of Breastfeeding Mothers is a UK charity providing telephone and internet support. The ABM’s helpline is open every day from 9.30am to 10.30pm and is staffed by trained volunteers who have breastfed their own children. abm.me.uk/0870 401 7711

The Breastfeeding Network runs a phone service, which will connect you to a breastfeeding supporter in your area. The line is open from 9.30am to 9.30pm every day of the year. breastfeedingnetwork.org.uk/0870 900 8787

La Leche League offers mother-to-mother support, encouragement, information and education – check website for details. laleche.org.uk/0845 120 2918

National Childbirth Trust Qualified NCT breastfeeding counsellors can help overcome problems and deal with practical issues around breastfeeding. The helpline is open seven days a week from 9am to 6pm. nct.org.uk/0870 444 8708

Mums like you

‘While I was pregnant, I knew I wanted to breastfeed. But right at the beginning I suffered with cracked nipples. I thought Jamie wasn't latching on properly so I contacted a breastfeeding counsellor who was very helpful. Without her, I think I would have given up when Jamie was six weeks. As long as mums have the right support they can succeed.’

Jo Philips, 27, from Wolverhampton, mum to Jamie, nine months

‘I used to feed Joshua and put him straight down to sleep, but it took me ages to get him to settle without a feed once he was weaned. With Emily, I read to her for a little while after her feed and before putting her to bed so she doesn’t associate feeding with getting to sleep.’

Mandy Scott, 37, mum to Joshua, five, and Emily, four months

‘Ask your midwife to show you how to breastfeed lying down on your side so you can do it in bed. It’s a lovely, relaxing way to feed and makes all the difference at 4am!’
Sue McGregor, mum to Rachael, eight months

‘Don’t try feeding your baby if he’s having a paddy because he won’t latch on properly and you’ll both end up even more frustrated. Calm him down first and then put him on your boob.’

Samantha Jenkins, mum to Milo, two

‘When you’re sitting to feed, put a phone book under your feet and use a pillow to support your back, and your arms if necessary. It makes it easier to position your baby properly and you don’t end up with sore muscles from tensing.’

Jacinta Reynolds, mum to Billy, two and Teddy, six weeks

‘Summer would feed for a few minutes, then fall asleep, so I seemed to have her permanently attached to a boob trying to get her to take enough milk. My midwife told me it was OK to wake her up by gently wiping a damp flannel over her forehead, or to try tickling her feet, and it worked!’

Rebecca Coulston, mum to Summer, four months

Q&A

How do I know if I’m producing the right amount of milk for my baby?

Lactation expert Katie Fisher says: ‘You will make the right amount of milk providing your breasts are stimulated frequently by your baby. Signs that he is getting enough milk are yellowish poo, four to six wet nappies a day, being settled between feeds and gaining weight.’

Is it normal for my baby to feed every hour?

Katie says: ‘In the early days following birth, this would not be unusual. Once breastfeeding is established most babies have a period during the day when they 'cluster feed' (feed very frequently). Most mums find that this is usually in the early evening. It is important to offer both breasts at each feed, even though your baby may choose to feed from just one.’

What are ‘growth spurts’ and how do they affect my baby’s feeding?

Katie says: ‘These are normal physiological events, and are your baby's way of increasing your milk supply for the following weeks. They present as a day or two of frequent agitated feeding, resulting in a larger weight gain.

These days can be very difficult to cope with and the best plan is to try and do very little other than feed. Sadly, if mums are not aware of what a growth spurt is they might think they don’t have enough milk and give up, or use formula for some feeds, which can interfere with increasing their milk supply.

Expect to have growth spurts at two to three weeks and again at five to six weeks.

Body maintenance

Your baby gets his nourishment directly from your body when you breastfeed, so looking after yourself properly is the best way to ensure he gets the milk he needs and your body copes well with the demands made on it.

Eating a healthy, balanced diet, drinking lots of water (at least two litres a day) and getting enough rest are vital for a breastfeeding mum, and this is definitely not the time to start worrying about shifting those post-baby pounds.

When it comes to feeding, your breasts are pretty low maintenance. Your baby needs the natural bacteria present on your skin to keep his gut healthy, so you don’t have to worry about cleaning your nipples before feeding.

Your nipples also secrete a natural lubricant to keep the skin moisturised, so healthy breast skin doesn’t require anything more than exposure to the air a couple of times a day for around 20 minutes to keep it dry and comfortable.

Pick your times though, hanging your boobs out for an airing while your in-laws are visiting probably isn’t a great idea!