Breastfeeding: As a parent-to-be, you’re looking forward to the experience of connecting with your newborn this way. But you’ve also heard it’s going to hurt. You’ve been told that cracked, bleeding nipples, soreness, and anxiety about milk supply are all in your near future. Maybe you already experienced those things the first time around. But the truth is, pain and suffering do not have to be part of the breastfeeding equation. In fact, cracked, bleeding nipples and soreness are all signs that you need to tweak something in order to make the breastfeeding experience better—much better—for both you and your baby. Pain and damaged nipples should not be considered the norm. 
Arming yourself with a few key concepts ahead of time can help you get breastfeeding off to the best start possible, minimizing pain and increasing the likelihood of a good supply. As a professional doula and lactation specialist, I know that many new parents are swimming in way too much information and feedback about caring for their infants. But sometimes in that flood of facts, the information you need in those first few days gets lost. In the spirit of getting you and your baby off to a great start, here are my top five breastfeeding strategies for new parents!
1) Learn the basics of breastfeeding before you have the baby: Take a prenatal breastfeeding class or read a breastfeeding book. Anything you can do to learn the very basics will help you feel more confident when you have your baby.
2) Understand how breastmilk production works: Breastmilk production is linked to how often your baby suckles. Let your baby suckle 8-15 times per 24 hours in the first three days. It seems crazy, but it’s true—newborns will suckle up to 15 times per day. Your first milk is called colostrum, and it comes in tiny amounts. Nothing produces more concern in the new mom than worrying that she doesn’t have enough milk—and who can blame her? Let’s rename colostrum “newborn milk.” Those tiny amounts are all your baby needs. Newborn milk is thick, sticky, and yellowish—it’s rich with antibodies, and very laxative in order to help the newborn pass its first stool (called meconium). Your baby will only consume 1-2 tablespoons in the first 24 hours!Newborn Milk becomes Mature Milk by Day 3, or in 72 hours, in most cases. This milk is the whitish, flowing, liquid substance you are more familiar with. A good latch ensures a good milk supply. Pain is a sign of a poor latch—and a poor latch means you are likely to produce less milk. With a good latch, the baby’s mouth is wide open, the baby takes a big amount of breast tissue in the mouth, the lips are flanged, and the nipple is not compressed.
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3) Ask your care provider ahead of time—and your nurse in the moment—if you can have your baby placed on your chest immediately after giving birth for skin-to-skin (if all is medically well), and ask if you can delay newborn procedures so they don’t interfere with initial breastfeeding: The American Academy of Pediatrics (AAP) now recommends that babies be placed in direct skin-to-skin contact right after the birth to help with breastfeeding. The AAP also recommends that newborn medical procedures (such as eye ointment, weigh-in, and a Vitamin K shot) should not interfere with mother’s breastfeeding.
4) Ask for a visit from the hospital or birth center Lactation Consultant: There is no substitute for live, in-person help when it comes to the sometimes complex dance that is breastfeeding. Hire a private lactation support person if your hospital isn’t equipped to offer you one-on-one help or if you are feeling pain or uncertainty. These visits are almost always covered by insurance.
5) Avoid bottles and pacifiers in the early days of breastfeeding unless medically indicated: Remember, although it may feel like you don’t have enough milk in the first 24-72 hours, your colostrum is typically all the baby needs, unless you have been told otherwise by your doctor. Bottles are much easier for babies to suck from than breasts. Once your baby knows how to breastfeed, going to a bottle is no problem. But moving the other way around is much more difficult! Bottles don’t make babies open their mouths as wide as they need to for breastfeeding. Bottle-learned mouth positioning can cause pain for the mother as well as poor milk transfer. As soon as breastfeeding is well-established, the baby can easily go from breast to bottle. Early supplementation with a bottle can lead to moms making less milk, simply because her breasts are not being stimulated enough. In most cases, breastfeeding just works right off the bat—and that’s a beautiful thing. But if you are experiencing pain and nipple irritation early on, my last tip is to place a call to a professional lactation support person. I’ve seen firsthand how quickly a one-hour consultation can turn a freaked-out mom into a breastfeeding pro. “No pain, no gain” is a truism that definitely does not apply to breastfeeding, as pain is very likely a sign that something isn’t right.
6) Don’t judge yourself: The most important thing is that you feed your baby, one way or another. Every parent has to decide for themselves what is the best way to feed, parent, and nurture their child. Be gentle with yourself as you work on breastfeeding.
Jada Shapiro is the mother of an 8-year old daughter and is the founder of boober, where new parents go for on-demand, in-person breastfeeding help; and Birth Day Presence, a trusted local Childbirth Education Center and Doula Matching Service. To learn more about her, visit getboober.com & birthdaypresence.com!
