It’s natural, it’s healthy, and your baby comes ready-made with a set of instincts that tells him or her where your boobs are and what they’re for. Does that make breastfeeding easy? For many people, no. It’s been suggested that – partly owing to a generation of women in the West being convinced by commerce to use bottles instead, and partly because we no longer live in tribal communes where everyone watches and helps each other raise children – today’s women have sort of lost the knack of breastfeeding. Certainly the number of guides and online advice forums on the subject seems to suggest we need help. But – for me at least – some of the terms used in textbooks and online how-tos ended up confusing me more than helping; so here’s my guide to breastfeeding guides and what they actually mean.
(Note: I’m not a La Leche League volunteer or qualified to be, as I’ve only fed my daughter for five months so far; I’m just a mummy, standing in front of a baby, asking her to feed).
(Note 2: breastfeeding isn’t for everyone. No judgment here.)
BEFORE YOU BEGIN
What’s the one thing everyone, absolutely everyone, knows about newborn babies? You have to support the head. This is true – babies don’t develop neck control for some weeks after birth – but fears of causing neck injury leads a lot of new mums to hold the baby’s head tucked towards the chest, in a position he or she can’t feed in. Support the head gently (thumb and middle finger behind the ears is a good place to start), but allow the head to fall back so that baby can swallow easily. This is really quite far – it will look a bit alarming in the beginning, but you need that tilt back.
Then most guides to breastfeeding start by saying something like:
LEAD WITH THE CHIN
What not to do: leave baby’s chin dangling in mid air when you bring her on to latch.
What does it mean, then? I had absolutely no clue what this oft-repeated phrase on the breastfeeding pages meant when we started out, and I’m a trained dancer used to initiating movement with all parts of my body. It really means: get your baby in a gently supportive grip as above, and bring her to the breast with the head tilted back so that the chin is the first part of her head to make contact. The chin should really be on there (I feel like not enough breastfeeding guides make this clear – there should be solid contact between chin and boob) and then you’re ready for the next step:
ALIGN BABY’S NOSE WITH YOUR NIPPLE
What not to do: visualise some kind of line in space measuring six inches between your nipple and baby’s nose, as I did for several useless attempts.
What does it mean, then? When a written guide invites you to “line up” parts of your anatomy with your baby’s, it means something more akin to “stab”. Holding your breast between finger and thumb, prod your baby right in the nose with your nipple. Make actual physical contact. Keep your nipple pointing upwards as you stroke down toward’s baby’s mouth, which should open nice and wide in response, then bring her over the top to latch.
BRING BABY TO THE BREAST
What not to do: huddle over baby and sort of stuff your boob into her mouth.
What does it mean, then? Obviously you bring the baby somewhere near the breast in order to start the nursing process – you don’t squirt milk into her mouth from a distance of five feet. What this well-intentioned but often difficult-to-follow advice really means is: resist the impulse to cradle yourself over baby, rolling your shoulder forward and hunching over her. Lifting baby to the breast and leaning back on something comfortable will prevent back and shoulder pains, and should help you get baby properly latched on, too. Instead of stuffing your boob in or letting baby slurp it into her mouth, bring her up and over the nipple and areola so her mouth comes completely over the top – it looks a bit like a woodentop puppet snapping shut to begin with, but this should ensure you have the correct quantity of boob in the mouth.
You may find you want to hunch over at the beginning: you might feel like you’ll drop her if you lift her up, or that she’s heavy on your arm, or that you simply want to snuggle close – feeding pillows and a good armchair can help while you’re getting used to positioning in the beginning. Once you get the hang of things, you’ll be able to feed on the uncomfortable armless chair at the GPs, on a bench at Morrison’s, on a pile of flatpacks at IKEA or even sitting crosslegged on the floor with no problem at all. While you’re getting going, however, cushions and supports are your friend.
So to recap: in roughly this order, you let baby’s head tilt back as you bring her chin right onto your breast; stab her in the nose with your nipple and flip that into the mouth that should now be open; then bring her over the top like a woodentop. This all happens in just over a second, like chin-stab-over; with practice, your baby will learn what’s happening and co-operate nicely for you. For bonus points, hold your boob in the shape of her mouth (squeeze it vertically if she’s lying in cradle hold, or horizontally if you’re doing football hold) – but if you feel like you’ve run out of hands by this point, don’t sweat this part.
Yes, yes, if you latch perfectly you won’t get cracked nipples. And whoever did anything perfectly the first time, or even the first dozen times? In the meanwhile, you have a hungry infant suckling on you several times a day, and your boobs are doing a whole new trick that they’ve never previously done before, so they’re going to need some TLC. This is my favourite resource on dealing with nipple pain and cracks, but the tl:dr is:
- invest in some medical-grade lanolin before you begin breastfeeding, and wipe a little on after each feed
- silicone nipple shells worn after feeding help prevent chafing and promote healing; another option is to simply not wear clothes on your upper body, which was my default for the first few weeks (but that was a warm autumn)
- nipple shields worn during feeding are sometimes not recommended as they can interfere with latch, but they can help through the odd rough patch if bad cracks are getting you down.
- a little breastmilk patted into cracks after feeding can help, but be a bit judicious if you suspect you might have a yeast infection (common after antibiotics).
- if your cracks get very severe speak to your midwife or GP – there may be an underlying problem.
Once you’ve got used to the tingly feeling of letdown, found your preferred way of latching on, and relaxed enough to lean back into your sofa or your pillows at night, breastfeeding should feel quite nice. I think the LLL goes a little over the top with the title of their manual, “The Womanly Art Of Breastfeeding”, but the process should feel pleasant for both of you. Even in the middle of the night, nursing brings an opportunity for closeness and cuddling; it’s satisfying to be able to soothe and feed your baby using only the body nature gave you; and you just don’t get that oxytocin hit with a bottle. If nursing feels painful after the first few goes, again seek help. You may need to fix a problem latch, or an underlying physical issue.
There are lots of videos online and they are helpful, although they all seem to feature bountifully bosomy women with battle-hardened nipples feeding large, older babies with good latches and superior head control. If anyone can point me to a video of an actual new mum feeding an actual newborn with a floppy neck and a little tiny mouth, let me know because I was never able to find one when it would have been really handy.