From positioning to latching to eating, to milk supply

How to tell if your baby is hungry

They’ll just cry, right? Yes, babies will cry to let you know, but there are other things that they will do first. Recognizing the early cues makes it easier to get a baby latched. Trying to get a screaming, ravenous baby latched is much harder. It’s less stressful for everyone. Less stress equals more success!
Cues include baby’s hands to their face, if they’re sucking on their hands, and moving their heads around looking for mama or bobbing their heads- my husband and I would call this “woodpeckering” because our babies would repeatedly tap their heads against our chest and it reminded us of the bird. All of these are indications that it’s time, and ok, to go ahead and feed baby- even if an adoring family member is holding them😊

How do you hold a baby when you breastfeed?

Well that’s up to the two of you. There are a couple of different holds, but ultimately, there is no right way. It’s up to you and your baby to do what is most comfortable for the two of you.

• Cradle- this is where your baby’s head is cradled in your elbow as seen below.

Cradle was my preferred position with my first. That baby was born knowing how to eat! He came out rooting and found my nipple within a matter of seconds from being placed on my chest! This position just felt the most natural to both of us. I could see his little face and adoringly stroke his head or hold his hand with my free hand. This position is the one that when we were young girls would be how we carried around our baby dolls.

• Cross-cradle- Very similar to the cradle, but rather than the baby’s head being in the crook of your elbow, their rump would be resting there with their back lying on your forearm and their head would be held in your hand. The baby would be coming across your body to nurse on the opposite breast. This position is especially effective if you have a baby that is struggling to find your nipple or to latch. Their rooting reflex is intact, with your other hand you grab your breast and stroke their cheek getting them to turn their head with an open mouth. When this happens, the magic comes from the hand that is holding your baby’s head. With gentle firmness and confidence, press your babies head into your breast. Once latch is established, ever so slightly turn your hand to allow the baby’s nose to be more open.

The cross-cradle was necessary (and a life saver!) in the early days with my twin baby boy. He would get easily frustrated and worked up so the cross-cradle would allow me the extra assertiveness to help him get latched quickly.

• Football- Think of how a running back holds and protects the football. You’re going to hold your baby the same as with the cross-cradle, (rump in elbow, head in hand) but rather than the baby coming across your body to the opposite breast, your baby will be tucked back with your elbow inline with your back and their head being at your same breast as the arm that you’re using to hold them.

This was my least favorite with my first, but absolutely necessary with my twins to be able to tandem feed. It felt a little unnatural at first, but after a couple of feedings, I got use to it, and it was the easiest.

Rooting

This is a reflex that all babies are born with for survival. Rooting is the all encompassing term for when a baby is looking around, moving their head and face, searching for a nipple to latch on to. If something were to brush their cheek they would turn their head toward the item with an open mouth. This comes in handy when trying to get a baby to latch.

Latching

Latching is just what it sounds like. This is when your baby connects with suction on to your nipple ready to eat. Ideally, the babies tongue should be down and their mouth should have most all of your nipple and areola- the darker skin surrounding the nipple, in their mouth. Babies are born knowing how to do this.
With your nipple, stroke your baby’s cheek and they will turn their head with an open mouth towards your nipple and latch on.

There may be some challenges that could make getting a good latch difficult- ie the size of your nipple could be too big for your baby’s mouth. This happened to me, but is a pretty easy fix that just takes time. As my babies grew, so did their mouths, therefore eliminating that issue. Other issues that could contribute to a poor latch include a tongue tie or a lip/ gum tie- this is when that thin piece of tissue that is under the tongue that anchors it to your jaw, or those thin strands of tissue that run from your gums to the inside of your lip are too short/ tight. This makes it difficult for the baby to create suction. This also is an easy fix. The tissue can be cut by your pediatrician, releasing it and allowing the baby to more freely use his or her mouth.

It shouldn’t hurt for your baby to nurse. It may be a bit uncomfortable initially, but there should not be pain. Yes, your nipples may get raw in the first few days, and there are nipple butters to help with that, but there should not be pain. If there is, tell your pediatrician at a wellness visit. This could be an indication to look for a tongue tie or a lip tie.

Once your baby has latched they will being to suck in short, frequent, shallow sucks. This is to elicit your let down.

Let Down

Let down is a reflex that releases your milk from the ducts in your breast to allow it to come out of your nipples. Your baby is born knowing that the best way to do this is by stimulating your nipples. To conserve energy, your baby does just what is necessary to elicit this response, hence, the short, shallow sucks.

How do you know if you have let down? You will feel a tingling sensation in your breast that typically starts a little higher and then works its way down towards your nipple. This sensation is your milk being released.

Some women have a heavy let down and could spurt milk out very quickly which could choke the baby. Babies that are term usually are prepared to handle this. They will pull off, cough, and resume feeding once they have caught their breath, which usually is enough time for the stream of milk to have slowed down so that they won’t be choked again.

Nursing

Now that your baby has latched and your milk has let down, it’s time for baby to nurse. Your baby should have a coordinated pattern of suck, swallow, breathe. The sucks will be longer and deeper than when they first latched. Feeding should typically last 10-15 minutes, but shouldn’t go longer than 20 minutes. This is a sufficient amount of time to allow your baby to get the protein rich foremilk and the fatty hindmilk. Anything longer than 20 minutes and the baby will be burning more calories than they are consuming.

As your baby gets full, their tone will decrease and their hands will start to fall away from their face. This is how you will know they are done, even if they are still latched.

But how do you know if they got enough? If your baby is producing 6-8 wet/ dirty diapers in a 24 hour period and is gaining weight, then they are getting enough. Allowing your baby to be driven by signals from their body will translate to healthier habits and relationships with food later in life.

How often will my baby nurse?

Typically, a baby will eat every 2-3 hours. breastmilk feedings tend to come more frequently than formula and bottle feeding. Some babies may eat more like every one and half hours in the early days when their stomachs are smaller and may get closer to every three hours as they grow and their stomachs get bigger. The exception to this is cluster feeding.

Cluster what?

Cluster feeds are frequent feedings that go on all day that usually coincide with some a growth spurt. They often are 10 minutes of feeding followed by your baby sleeping for 20-30 minutes, followed by another 10 minutes of feeding, another nap, another feeding, and so on. It usually lasts all day and you should just expect to hang out on the couch all day with your favorite little person, snacks, and plenty of water. If you’re wondering if you will have enough milk for this, you will. But let’s talk about supply.

Milk Supply

This can be a little scary, but don’t worry. Your milk supply is related to the demand that is placed on your body. If your baby keeps saying I need more and keeps stimulating your breasts, your breasts will keep producing more. It’s a positive feedback loop. If your baby starts sleeping through the night, therefore is not stimulating your breasts at night, your breasts will start producing less milk. Your breasts will synchronize to the needs of the baby and produce based off of what they demand. If there is an uptick in the demand after there has already been a step back, your breasts will respond accordingly and produce more. After a day of cluster feeds your breasts may seem fuller if your baby is back to regular feeds the next day, but this will not last either as the production will slow down if your baby slows down.

But what about when? Like when will my milk come in?

Typically within 2-4 days after the baby is born. This does not mean not to feed your baby until then. You absolutely should be feeding your baby every 2-3 hours. You have colostrum, which is nutrient rich and necessary to help your baby pass their first stool and get through the first couple of days until your milk supply comes in.
Be ready when your milk does come in because you will have breasts up to your chin. They will be tender, but this will not last more than a couple of days. Your body will acclimate to the needs of the baby and your breasts will go down in size.

What about establishing a supply?

This is done by feeding your baby every 2-3 hours. The more your breasts are expressed, the more milk they will produce. Whether it be that the baby is nursing, you are pumping, or hand expressing, the key to getting more milk is to keep getting the milk you have to come out. Sometimes the challenge lies there.
This could be as simple as needing a more relaxing and private environment so that you can allow your body to let down and to have all the cues to trigger hormones necessary for milk production and expression. For example, looking into your baby’s eyes increases oxytocin which increases milk supply, as does skin to skin, and holding, seeing, and hearing your baby.
It could be a little tricker though. You may have a breast shape or nipple shape that may make nursing harder. A lactation consultant could be an invaluable asset! If their tips and tricks don’t seem to be helping, it may be worth asking your doctor to explore your thyroid. If you have known thyroid issues I would not hesitate. Too much thyroid hormone will prevent the necessary prolactin to let down your milk.

Should I see a lactation consultant?

I cannot say enough good things about lactation consultants. They are masters of this art and have a wealth of knowledge that I do think every mama should take advantage of. If you have your baby in the hospital, the facility should have a lactation consultant that you could see before going home. Many hospitals also offer the ability to do drop in services should you desire a lactation consult after discharge- check with your facility, OB, or community to utilize this resource. It’s totally worth it!

I didn’t have any trouble whatsoever nursing my first child, but I did see lactation just to see if there was any useful advice that I could use. But my twins were different. They were born a little sooner, they were smaller, and there were two, so I felt like I could REALLY use some help navigating. I spent 5 minutes with an amazing lactation consultant, and she had me and my babies ready to go in no time. It clicked for all three of us, and I’m not sure that would have happened without her guidance- all because she was the expert and could provide expert advice,

I hope you found this article helpful. Happy Nursing!!!

Disclaimer: This is not intended in anyway to be medical advice.