2.1 Breast-feeding

A baby should be put on breast as soon as she is born and is crying vigorously. In case of caesarian section, the baby can suck from the breast as soon as the mother wakes up from the effect of anesthesia, i.e. about 4 to 6 hours after birth. She can keep on lying down, while someone else holds the baby and let the baby suck from the breast. You should tell the nurses in the nursing home or hospital that you want this to be done. Ask them not to give the baby a bottle at all. Only exception is when the mother is too ill and not able to feed the baby. For the first 1 or 2 days, milk secretion is very little in quantity and yellowish in color. This is known as colostrum. If the baby sucks well on the breast, then this amount of milk is enough for her. Initially she will probably demand it frequently, but very soon, you will find that enough milk will be secreted and your baby will sleep well in between the feeds. Actually the more the baby sucks on the breast, more milk will be secreted, as when the baby sucks, mother’s body gets the signal that milk is needed and therefore more milk will be produced.

At times, there is a problem initially in making the baby latch on the breast and thus she is not able to suck. This usually occurs if the baby has been given bottle feed before putting on the breast, but it may occur otherwise also. It may be because the way you are holding the baby, you and your baby are not comfortable or it may be due to flat nipple. You can try giving baby breastfeed while lying down.

Flat or inverted nipple is one of the commonest reasons for difficulty in making the baby latch on to the breast. The treatment for this should start when the mother is pregnant. She should pull the nipple out a few times a day after applying some cream. When the mother, who has flat nipple, is having difficulty in trying to feed the baby in spite of all the attempt of pulling out the nipple, she can use nipple shield for a while. After a few days, she will find that the baby will be able to suck without the nipple shield. Once the baby latches and sucks well on the breast, there is no reason why she will not succeed in breast-feeding. If your baby is born prematurely then the baby may not be able to suck well on the breast. In such a case, you may have to express the breast milk and give it to the baby with a bottle or a spoon. However if the baby is very premature the baby will have to be given expressed breast milk with a feeding tube. This is always done in a hospital or nursing home and by the nurses, who are experts in feeding these babies.

When the baby sucks over the breast, see that the areola (the dark portion around the nipple) is in the baby’s mouth. Sucking directly over the nipple alone causes cracked nipples. Also too much cleaning the skin over the nipple also causes dryness of the skin which causes cracked nipple. It is not advisable to clean the nipple before each feed. Cleaning once a day while taking bath is enough. Once cracked nipples occur, as this is very painful, it becomes very difficult to feed the baby. You can apply some lubricating cream over the nipple, after feeding, to ease the pain and help in healing. If the cracking is very severe, then you may have to stop feeding the baby for a day or two and give the baby expressed breast milk with a spoon or bottle. Do ask someone, who has experience in breastfeeding to help you.