Although the staff in the delivery room know exactly what to do immediately after birth, you should not let the process take its course. Unfortunately, only 45% of newborn babies worldwide are breastfed within one hour of giving birth. In the best-case scenario, the first breastfeeding after birth occurs approximately two hours later in the ward.
An interesting fact. Breastfeeding mothers who start working are considered more valuable workers than those who feed their infants formula. Artificially fed babies are sicker, heavier, longer, and their mothers miss many more work days.
Many women’s clinics hold in-person and online classes to learn how to prepare for breastfeeding, how to start breastfeeding, and to try different breastfeeding positions.
You should talk to the staff ahead of time, think about which of your loved ones will make sure everything is done right during labor and delivery, so that you will be placed in a mother-baby room together afterwards. So that it doesn’t happen:
- Separation of mother and newborn;
- Replacing the first breastfeeding with formula from a bottle with a pacifier;
- The baby was not given a glucose solution or water.
If this happens, the risk of problems with breastfeeding increases many times over.
The first few hours and days of life are a critical period for the establishment of lactation and successful breastfeeding. The only exception may be 100% medical conditions on the part of the mother or baby.
What you need to know about breastfeeding by the due date
The first few hours and days of a newborn’s life are a critical period for the mother’s milk production, the successful initiation of breastfeeding, and the health and development of your baby.
During the first two to three days, when colostrum production and release occurs, a woman’s breasts feel soft and «empty». This is the norm.
In order not to wash away your natural protection, get in the habit of washing your breasts with warm water, then blotting them with a towel. It is enough to do it once a day: this will be your preparation of the breast for feeding. It is not recommended to use soap, any soap products, to rub the skin of the breast and nipples intensively with a stiff towel.
Do I need any other nipple preparation for breastfeeding? Nipples come in different shapes: expressed, flat or retracted. Expressed nipples are more comfortable for the baby when the mouth grips the breast than flat and retracted nipples.
There are still recommendations to stretch or rub the nipples, especially the retracted and flat ones. Or wear a nipple shaper for 3-4 weeks before labor, — such a silicone cap with a hole in which the nipple is pulled out. However, the best nipple shaper is the baby. Remember that the newborn does not suckle on the nipple, but on the breast, grasping the areola, so the very first feeding after birth is crucial. If you get a successful and correct breast grip, all subsequent feedings will be successful as well.
It makes sense to use nipple shapers when a woman had to stop breastfeeding for medical reasons after giving birth and the baby was fed from a bottle. In this case, to make it easier for the baby to get used to the breast, it is recommended to put nipple shapers half an hour before each feeding and use the nipple shapers that resemble the shape of a nipple.
If you can’t prepare ahead of time, don’t feel bad. You do not have to worry that you do not know or cannot do something. Neonatologists, obstetricians, gynecologists, nurses and midwives have special training. The entire staff is able to answer most questions that arise for women in labor and provide appropriate help and support.
Skin-to-skin contact and first breastfeeding after delivery.
It is ideal if skin-to-skin contact and the first breastfeeding after birth occur simultaneously. For example, if the birth is normal and the baby is born healthy, with a score of 7-10 on the PPGAR scale.
Immediately after birth, the midwife pinches, cuts the umbilical cord, and places the baby’s tummy on the mother’s naked belly. The newborn crawls reflexively and pulls itself up to the breast, which is already ready to release colostrum from the nipples. About 15-20 minutes after birth, the baby finds the nipple. Everything happens reflexively, the baby only needs a little help. A few sucking movements are enough, then the baby lies on the mother’s chest. They are covered with a diaper, because the baby’s skin is wet after extraction, and the temperature in the birth room is uncomfortable for wet skin.
Skin-to-skin contact should be continuous for 60-120 minutes.
What does early breastfeeding and skin-to-skin contact do?
- The taste buds on the tongue are calibrated to women’s milk and to the composition of women’s milk in general, which is what should go into the baby’s mouth first (not water, not glucose, not formula). This determines the taste preferences for the future.
- The baby’s adaptation to the environment is facilitated
- The newborn’s physiological search reflex is stimulated so that a skill such as breast searching and sucking is formed and solidified.
- The newborn’s skin and intestines are colonized with his mother’s microflora.
- The baby gets warmed by his mother’s warmth and the cooling of his body is prevented.
- The baby hears his mother’s heartbeat and becomes calmer.
- Touching and hugging simulates the production of oxytocin, uterine contractions after delivery, improved lactation, the release of milk in the mammary glands through the milk ducts.
After the stress, incredible effort and pain that accompanies childbirth, the baby is provided with the contact-comfort of a loved one, which has a tremendous impact on his entire future life. The production of stress hormones immediately decreases. The feeling of safety, warmth and love coming from the mother (or father) is a factor beneficial to the character, further development and formation of the child.
Imprinting — imprinting the mother (and other relatives) in the memory of the newborn as the most important people in his life. People whom the newborn feels, sees, hears in the first hours after birth remain in his memory, in his subconscious for the rest of his life.
That is why in the first few days after birth, being together with the baby is of particular importance: it is then that the baby forms a stable bond with the mother and close relatives.
Benefits of breastfeeding
The main advantages of breastfeeding have been pointed out since the 19th century.Breast milk contains factors that stimulate the development of bifido and lacto bacteria. These bacteria help to digest and assimilate food and, prevent unwanted and harmful bacteria from developing.
The advantage of breastfeeding is that a child who is breastfed more easily adapts to the adverse effects of the environment. This is due to the presence of adaptogen hormones (glucocorticoids, thyroid hormones, catecholamines) in a woman’s milk. Their need increases sharply under any stress: crying, cold, hunger, illness, etc.
The importance of breastfeeding for the growth and development of the baby is not only in the optimal supply of appropriate nutrients, but also in the peculiarities of communication between the baby and the mother during breastfeeding: talking with the baby, the mother’s smile, pleasant contact with her, familiar smells and tastes, the satisfaction of the sucking reflex, the feeling of love that the mother feels. All this gives the baby peace of mind and a feeling of security.
From the first days of life, these children are emotionally and motorally active earlier than children fed artificially. They develop speech earlier.
Benefits of breastfeeding for the mother:
- Stimulates the production of hormones that help the body recover faster from pregnancy and childbirth;
- Helps burn extra calories and normalize weight (extra energy is needed for milk formation, up to 500 kcal per day;
- Saves the family money (adapted formula is expensive);
- Convenient and practical: always available, absolutely hygienic. When you are away from home you don’t need to prepare baby formula in advance or hastily;
- Does not require much preparation and allows the mother to spend more time with the baby;
- Promotes mutual understanding between mother and baby.
Breastfeeding is more than just food. As a food product it can to some extent be replaced by adapted formula.
Breastfeeding is the most important factor in programming the physical development, the immune system and the health of the child for many years to come. Also, breastfeeding lays the foundation for the implementation of the health program, written in the DNA, in the distant future, years and even decades from now.
The WHO’s challenge for health professionals is to ensure that breastfeeding and the mother’s nutrition are at an appropriate level. The physiology and naturalness of the process is that the preparation of the mammary glands for lactation begins during pregnancy.
Preparation of the mammary glands for lactation during pregnancy.
Preparation of the breasts for lactation begins with changes in the hormonal background. Hormones stimulate the growth and development of the alveoli in which milk will be produced. As a result of an increase in the number and size of the alveoli, which are at the tip of the milk ducts — the breasts increase in weight and volume. This happens gradually, with each month of pregnancy. Usually, both breasts in women weigh on average about 200 grams. From the 7th month of pregnancy, their weight reaches 400-600 grams, after birth — increases to 600-800 grams. In general, by the time of delivery, the weight and volume of breasts increases 3-4 times.
The release of colostrum during pregnancy is one of the signs of physiological readiness of the breast to feed. You should by no means decant it during pregnancy. In some cases, the expectant mother should consult a gynecologist or mammologist, if:
- Droplets of pus or blood come out at the same time as drops of colostrum;
- The discharge has an unpleasant smell (normally it is milky, sweetish);
- Colostrum is actively oozing and there is a pulling pain in the lower abdomen;
- The breasts are painful and tight or there are nodules and lumps;
- The skin of the breast is red and hot.
Staying together is a great way to establish breastfeeding after childbirth, to develop your own routine. When the mother is with her baby, she is able to look at him, care for him, understand if the baby is getting enough to eat. As a result, the baby and mother feel calmer and more confident. In the first few days, most babies need more frequent breastfeeding to satiate. Breastfeeding «on demand» after childbirth helps to prepare the breasts for feeding more quickly and easily and to establish lactation.
The woman recovers from the birth more quickly psychologically
Close communication with the baby, understanding that the mother is the main person in the life of her child, helps women to cope with unstable hormones, the main cause of depression after childbirth. The calmness and equilibrium of the mother is transmitted to the baby, especially when you take him in your arms. The newborn’s nervous system and digestive tract work much better.
The baby develops a basic trust in the world
The period after birth is the most delicate in a baby’s life. The baby calms down and feels safe when he hears familiar voices and sounds, just like during pregnancy. When the mother and father hold him and take him in their arms, he feels the energy of his parents’ love. This creates the feeling that the world around him is safe, cozy, and welcoming.
Being together with the baby contributes to the formation of bonding.
A woman who is close to her newborn baby right after the birth naturally begins to understand his or her needs.
Bonding is a subtle intuitive connection, more than love for her baby or maternal instincts. A mother intuitively begins to understand and anticipate the needs of a child who cannot yet express them in words. It is an understanding without words, by sound, gesture or facial expression. It is what allows the mother and child to remain united even after the birth. It cannot be taught. This is why it is so important to start breastfeeding immediately after birth, and to stay together in the first minutes, hours and days of life.
The first days of life are extremely important for the formation of health and a balanced psychological state. If there is no possibility to provide constant physical contact with the mother (or the father, other close relatives in case the mother is weak after childbirth and cannot always be with the baby), it will be much more difficult to form a sense of security and trust in the world around the baby.
Cesarean and breastfeeding
It is desirable to have the first breastfeeding after caesarean section already in the operating room, if the condition of the mother and baby allows. If the cesarean operation is planned, it is usually carried out after the onset of contractions. It is labor that triggers the start of lactation. If the baby is born by caesarean section, but the mother is conscious, the baby will be placed on her chest in the operating room.
After caesarean section the beginning of breastfeeding depends primarily on the anesthesia received by the mother during the operation. The newborn can be breastfed almost immediately after birth if the C-section was performed under peridural anesthesia. If there was general anesthesia, and the beginning of rv after cesarean is not possible immediately, the baby is placed «skin to skin» on the bare chest of the father, aunt, grandmother — any, very close relative. After general anesthesia, it takes about 5-6 hours until the woman regains consciousness and is able to feed the baby. There may be restrictions in rv after cesarean section, if the mother was prescribed antibiotics or other drugs. It is necessary to monitor the condition of the mammary glands and prevent lactastasis.
Colostrum is a short and important stage.
The appearance of colostrum is simply a sign that the body is ready for breastfeeding. The physiological preparation of the nipples for breastfeeding manifests itself in the fact that the nipples begin to darken and become more sensitive. The area around the nipples or areola begins to darken, increase in size, and lumps become visible — the Montgomery glands. The glands are getting ready to secrete fat that will moisten the nipples from the beginning of breastfeeding, protecting them from inflammation and infection. The smell of the fat is similar to the smell of the amniotic fluid the baby was in inside the uterus, so it is easy for the baby to find the nipple almost immediately after delivery.
Colostrum is secreted from the mammary gland for the first 5 days after delivery.
Using pacifiers and bottles with nipples for complementary feeding. The main reason why they should not be used is the serious physiological difference between feeding from a bottle with a nipple and the areola of the breast. If the nipple is used as a nipple, the baby will not get milk from the breast, because there is no milk in the nipple, but it is released when the areola is stimulated.
Practice shows that if the babies start feeding formula before they are discharged from the hospital, it is 2 times more likely that in the next 6 weeks they will be off the breast.
On the third day or later, the mammary gland becomes noticeably larger and denser, the transition milk begins to arrive.
By the end of the first month, the breasts begin to produce mature milk.
Medical contraindications to starting breastfeeding:
- After emergency cesarean section surgery;
- If the mother has severe diseases of internal organs in the decompensation stage;
- If there are complications during the Caesarean section operation;
- The mother has an acute infectious disease;
- The mother has a cancerous disease;
- The baby or the mother has an acute inflammatory process;
- The baby is in a serious condition, expressed general weakness.
When is decanting necessary?
All women should learn how to properly decant in the first 24 hours after birth and understand when it is necessary.
With properly established breastfeeding, it will not be necessary.
However, there are situations in which you can’t do without it:
- Feeding a baby born prematurely or with a low birth weight;
- Feeding a sick baby who cannot suckle enough milk;
- When a nursing mother goes to work or school;
- In a package of measures to relieve the condition of a woman with a heavy breast or lactastasis.
Elena Demchenko graduated from Donetsk Medical Institute named after M. Gorky with a degree in pediatrics.
Work experience in medicine: district pediatrician, neonatologist of the department of nursing extremely premature babies, joint stay of mother and child, resuscitation and intensive care of newborns.