Originally posted on March 30, 2011.
In a new post on our sister blog, Science & Sensibility, blogger and International Board Certified Lactation Consultant and clinician Edith Kernerman discusses key breastfeeding information for the first few days and weeks. As an expectant or new mom (and dad/partner too!), it’s helpful to understand what’s happening in your body during this transition, including what’s normal and what may signal a problem. Below are tips and information from Edith’s post.
“We know that newborn babies require nothing other than colostrum and that though it is not there in plentiful amounts it is adequate for baby’s growth and health.”
Colostrum, known as “liquid gold,” is the nutrient-rich substance that is produced in your breasts before and up to 10 days after birth. Many mothers and uninformed family members and care providers can become concerned that your baby is not getting enough to eat prior to your milk coming in. Except in very rare cases, the colostrum that is made in your body is all that babies need. Using a breast pump to encourage more milk is not necessary. It’s helpful to keep in mind that a newborn’s stomach holds 5-7mL, which is equivalent to the size of a marble or cooked chickpea. At seven days old, it’s the size of a ping pong ball.
“We know that a baby who is well latched with an asymmetric latch will get the colostrum that is there, and a poorly latched baby won’t, and yet we see thousands of mothers in our clinic who have been taught to latch baby symmetrically.”
An “asymmetrical latch” is one in which the baby takes more of the breast below the nipple than above. Once latched properly, baby’s top lip will rest just above mom’s nipple and baby’s nose will point up and away from the breast. Agood latch is the key to baby getting enough nutrition as well as comfort for mom and baby. Often, if a baby does not appear to be getting enough, adjusting your latch — not pumping — will fix the issue. And as a side note, Edith tells us:
“Colostrum does not respond well to a pump, it responds better to hand expression. And so when mothers can pump nothing, they are told they have no milk. Best to adjust the latch and use breast compressionsand watch for baby’s drinking (don’t listen, you are unlikely to hear a baby drinking at that age).”
“Contrary to popular belief engorgement is not a sign mother has a lot of milk. Engorgement is a sign things have gone wrong.”
Edith offers several tips to reduce and fix engorgement:
- Adjust latch so that it is asymmetrical and deep
- Use breast compressions while baby is feeding (find video and how-to here)
- Remain skin-to-skin as much as possible to read baby’s early feeding cues in order to feed frequently, as necessary
- Do NOT pump engorged breasts or massage downward toward the nipple
“We also know that a well-latched baby should not cause mother pain and yet women are told around the world to put up with the pain, or grin and bear it because it is supposed to hurt.”
As a veteran nurser myself, I will tell you (and most moms would concur) that breastfeeding does take some time for your body to adjust to the sensation. There is some initial discomfort, yes. But cracked, bleeding and “raw” nipples are NOT normal. If you do experience severely sore nipples or soreness beyond mild discomfort, seek the help of a lactation consultant. Many hospitals have these wonderful professionals on staff. If not, seek one in your area. Most likely, the cause of your soreness is a poor latch and a lactation consultant can observe and help you fix latch issues, or determine if something else is causing the pain. Edith also cautions:
“Mothers are also told to prepare their nipples (a completely non-evidenced informed practice!!) and to apply various creams and ointments on their nipples: petroleum jelly, lanolin-based creams, nipple balms—none has been supported by research. Some make matters worse.”