Starting breastfeeding-getting off to a good start

Babies have a strong sucking reflex early on, especially on the second and third day when they have recovered a bit from the journey from the womb to the world. This is also when the milk comes in, the breasts can get engorged and sometimes the milk can even overflow. It simply takes a while for the baby and the breastfeeder to adjust to the right frequency, you can see it as a teamwork where you often need to get to know each other a bit before things click. It often takes a few weeks for milk production to stabilise and for your nipples to get used to breastfeeding, and for you to feel like you’re starting to get the hang of this whole breastfeeding thing. But it is not at all uncommon that it takes longer than that and sometimes you need some extra support to progress.

Breastfeeding in the first hours after birth

Newborn babies have a strong urge to ‘suckle’ and can usually find their way to the breast on their own if given the opportunity to rest on their mother’s chest immediately after birth. Skin-to-skin contact is very important because it also stimulates the sucking instinct. Even with caesarean sections, skin-to-skin contact immediately after birth is now routine in many hospitals – researchers have even seen a difference in how quickly breastfeeding starts if the baby is against the mother’s skin or if there is only a towel between them.

Although the sucking reflex is strong, the baby doesn’t get very much milk at first, but this is compensated for by the fact that the first breast milk that comes in is particularly rich and nutritious. The first milk, which is known as colostrum, fulfils the baby’s nutritional needs until the regular milk comes in.

If the birth was complicated and you missed out on the initial skin-to-skin time together, know that this is not an obstacle to starting breastfeeding, but you may need some extra support in the beginning. Make sure you receive or request this help before you leave the hospital or clinic. In general, no matter how easy and natural or difficult and stressful breastfeeding feels, it’s a good idea to ask for help in the delivery ward to make sure your baby is correctly positioned at, and able to latch on to, the breast. If you have twins and want to breastfeed, it can be even more important to get help as there are two tiny people to get to grips with.

Getting started with breastfeeding – the right sucking technique

It may sound like the easiest thing in the world to put your baby to your breast, and the most natural thing you’ve ever done. That’s why lots of people are surprised and discouraged if they don’t succeed in breastfeeding right away. Finding the breast is usually not a problem for babies – that instinct is strong – but getting to grips with the actual sucking technique can be more difficult. This is necessary not only to ensure that the baby gets enough to eat, but also to prevent the mother from having problems such as sore nipples or engorgement.

If it takes a few days for your baby to get to grips with the sucking technique, it’s a good idea for the breastfeeding mum to keep the baby skin-to-skin as much as possible as this stimulates breastfeeding, and as an added bonus the breast is within reach whenever the baby wants to try. In the meantime, you can hand express your milk and give it to the baby using a spoon or cup. We know it can be challenging and seem a bit fiddly to use a spoon or cup, but apart from the fact that your baby needs the nutrients, breastfeeding also stimulates milk production. Try to see it as a step on the path to breastfeeding, and remember that it is actually very beneficial.

Breastfeeding tips

Learning to breastfeed is far from easy, but there are a few things you can do to make it easier.

1. Relaxing is important. Try to find a comfortable position to avoid tensing your muscles. If you are sitting up, try using a nursing pillow to lay your baby on. A traditional breastfeeding pillow is moulded to the body, but often a large pillow can work just as well. The point is for the baby to be at breast height so that your neck, back and arms can relax. The baby is supposed to come up to the breast, not the other way round, so don’t try to help by bending your neck or back.
2. It can also be helpful to have a stool at your feet to vary the position of your legs during a long feed – which most feeds are, especially in the beginning.
3. Place the baby so that your nipple is pointing towards the baby’s nose.
4. Make sure your baby’s tummy is resting against yours. Hold your baby against your tummy in a firm grip, while supporting his or her body.
5. The baby’s mouth should be wide open and cover the entire nipple, including the areola.
6. If you see that the baby’s lower lip is folded back and the part of the areola under the nipple is covered by the baby’s mouth, the baby is in the right position. It’s also a good sign if the baby’s jaw is moving, you can tell by looking at the ear that moves if the jaw does.

Breastfeed lying down, sitting down or using a baby carrier or sling

here are lots of breastfeeding positions and often the ones that are most suitable vary over time; but the principle is always the same: the baby should be able to find the nipple on their own and get a good latch, and the mum should keep her arms, neck and back relaxed. Perhaps the most common position is to sit up with the baby in your arms, but it is also possible to place the baby – or babies – to the side of your body in what is known as an underarm or rugby ball position. A lot of people like to breastfeed lying down, often on their side, but it is also possible to hold the baby across your chest if you are lying down on your back. Lying down can be particularly helpful for those who gave birth via caesarean section and need to be extra careful about pressure on the tummy and stitches. As long as you are relaxed, you can also breastfeed on all fours. A very practical and ergonomic way to breastfeed is to breastfeed using a baby carrier or sling, although this can take some practice to get right. If you are unsure, let the midwife at the hospital guide you, or ask a nurse or health visitor to help you try different positions when you get home.

The amount of breast milk is affected by how much the baby feeds.

Breast size usually has nothing to do with how much milk they can produce; the amount of milk is largely controlled by the baby. When the baby feeds, it sends impulses to the brain that release the hormones oxytocin and prolactin. Oxytocin is our feel-good hormone (the same one released by skin contact and touch) and it also stimulates the flow of milk, i.e. it triggers what is known as the let-down reflex. You may experience a numbing, tingling or rushing feeling in your breast when this happens. Milk can either trickle out or spray out quickly.

How sensitive your let-down reflex is can vary. For some, hearing their baby whimper or cry is enough to trigger the let-down reflex and start gushing milk, while for others it takes longer. It can also vary from time to time, especially in the first few months it is common to be surprised by a wet spot on your shirt.
It may be useful to know that oxytocin is sensitive to anxiety, pain and stress – the more negative emotions you have, the lower the levels of oxytocin released. This in turn causes the milk to take longer to let-down, which can lead to even more stress. Therefore, peace and quiet is needed in the beginning and if you’re still healing from birth or have postpartum depression, for example, it can be especially important

Prolactin, on the other hand, ensures the production of breast milk, so the more the baby feeds, the more milk is produced. If the baby feeds less, the supply of milk decreases. Then there are those who have higher levels of milk production, which can be noticed when the breasts feel very tense and sore. In this case, it can be a good idea to let some of the milk out before the baby breastfeeds, which usually makes it a little less painful. By applying heat to your breasts in the shower or with a heated pad, you can often manage to express some milk on your own, but you should not pump preventively as this only stimulates milk production. It’s not uncommon for the breast that the baby isn’t feeding from to leak, it’s actually a good way to naturally relieve the pressure, so put a towel underneath and let it drain.

During some growth periods, your baby needs to eat more than usual and you may find that there is not enough breast milk. But the more the baby breastfeeds, the more milk there will be. How often and for how long your baby wants to breastfeed is highly individual. Some find it hard to tear themselves away from the breast, while others are heavy sleepers and snack between meals, and some breastfeed very quickly.

The advantages of breastfeeding

There are many advantages to breastfeeding: it’s very convenient, the milk never goes off, it’s free and it’s always close at hand, as long as the breastfeeding mum is with the baby. Moreover, breast milk is also fully tailored to your baby and contains all the nutrients needed for the first six months – the only exception being vitamin D, which is given in drops. Breast milk also contains antibodies that give the baby some protection against certain infections in the early days. Another cool thing is that oxytocin causes the uterus to contract faster, which is one of the first steps in the body’s recovery after childbirth. It also appears that breastfeeding can reduce the risk of ovarian and breast cancer in those who breastfeed.

Partner support when breastfeeding

It is important to get help and support from those around you right from the start – a supportive partner can actually make the difference in whether breastfeeding is successful or not. The first and most important thing you should know as a partner is that milk doesn’t flow as well if the person breastfeeding is stressed or tense, so try to help create a calm environment – and let it take the time it needs! You can also think about taking more responsibility for other things at home, like taking care of the daily grind. Breastfeeding mothers are also likely to get thirsty and need to drink more since producing milk requires a lot of fluids. If you’re both home at the same time during the day, we recommend you visit the breastfeeding spot from time to time with a drink and snack – that’s usually appreciated.

Food – what to eat and what not to eat when breastfeeding

There are lots of questions about what not to eat while breastfeeding – generally speaking, most things are fine in terms of what does and does not pass into the breast milk. It’s also incredibly individual what your baby might react to, because tummy aches in babies are common and it’s almost impossible to know for sure what’s causing them. But if it seems like your baby is reacting to something the mother is eating, it is a good idea to talk to your healthcare provider so that you can get help to review the diet instead of starting to experiment on your own.

One helpful tip when it comes to food is that instead of thinking about what to avoid eating, it’s better to focus on what you should eat, as it takes a lot of nutrition and energy to produce breast milk. Preparing nutritious and varied meals as a new parent may not be the easiest thing in the world – we know that. But try to find a way to ensure that you don’t forget about yourself – set a timer to remind you to eat lunch or a snack if you have a hard time remembering. And ask someone else, if you have a partner or friend around, to help with the cooking. From a nutritional point of view, you could consider getting a few more calories, equivalent to about one extra snack, per day. Go for the calories in vegetables, root vegetables and berries – they are good for the environment and your health. Good fats that can be found in things like salmon, nuts and rapeseed oil. Vitamin D is also good for you and is often found in milk, yogurt and many margarines. You can find more tips on healthy and delicious food to make in our recipe collection, suitable both during and after pregnancy.

And there is also the matter of thirst. It takes a lot of fluid to produce milk, so it’s a good idea to keep a glass and a jug of water nearby. Try to drink at least one large glass of water per feeding, preferably more. When it comes to alcohol and breastfeeding, the Swedish Food Agency says that moderate amounts are unlikely to pose any medical risks to the baby – so if you’ve been longing to drink some wine during pregnancy but also want to breastfeed, you can treat yourself to a glass now and then.

If breastfeeding isn’t working out

For most people, learning to breastfeed is painful, but it should get better once the milk production starts. If the pain persists, we have some tips that may help. If you still can’t get it to work, there are several places to get help, so mention any difficulties at your first check up after the birth. Breastfeeding helplines that offer mother-to-mother support exist, and you can always speak to your healthcare provider. They can also advise if your baby has a tongue-tie, which can make breastfeeding more difficult.
If it still doesn’t work out, try not to see it as a failure, you did your best and it is possible to have equally nice and cozy moments together if you end up bottle feeding.

Please note that all information above is based on Swedish recommendations.