Positioning

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POSITIONING THE BABY CORRECTLY FOR NURSING
Breastfeeding is meant to be a pleasant, comfortable experience.  You can avoid the problem of sore nipples most of the time.  Many new mothers find their nipples are tender for the first few days when the baby starts nursing.  This usually disappears by 1-2 weeks.  To prevent nipple tenderness, correct positioning and latch on are important.  There are several different positions you can try.

CRADLE POSITION
Place a pillow or two in your lap to support the baby
Place your baby’s head on the crook of your arm
Support the baby’s back with your forearm
Your hand should cup the baby’s buttocks or thigh
Make sure your baby is turned towards you (chest to chest)
The baby’s ear, shoulder and hip should be in a straight line
The baby’s bottom arm can be either under your breast or around your waist

FOOTBALL OR CLUTCH HOLD
(The football hold is a good choice for the mother who has had a cesarean section because it allows her to breastfeed without putting pressure on the incision)
Place a pillow or two at your side to help support your arm and your baby
Your baby should be facing you while his body is tucked under your arm along your side
The baby’s bottom should rest on the pillow near your elbow with his hips against the back of the chair
The baby’s upper back rests along your forearm while you support his neck with your hand

SIDE-LYING
Lie on your side
You can put pillows under your head, behind your back and under the knee of your upper leg
Your body should be at an angle to the bed as you lean slightly backward into the pillow behind your back
The baby should be on his side facing you
The baby’s back should rest against your forearm
To keep the baby on his side, a folded towel or small pillow may need to be propped behind his back
You can offer both breasts while lying on one side or roll over for the baby to nurse on the other side

SLIDE-OVER
(The slide-over position can be helpful in persuading a baby who is refusing one breast to nurse on the less preferred breast)
The baby will start in the cradle position (see above) and nurse from one breast
When it is time for the baby to take the second breast, slide him over without changing his body position

CROSS-CRADLE
(Also known as the modified clutch or transitional hold.  This is an effective position for babies who are having difficulty latching on.)
Support the baby in your lap on a pillow in a horizontal or semi-upright position
Hold the baby using the arm opposite the breast at which he will feed
Your hand supports the baby’s neck and head, his body extends the length of your forearm
Use your same side hand to support the breast
Position the baby’s mouth at the level of your nipple with the baby on his side facing you

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Getting Started

Getting Started    
During the first few days after birth, many babies want to breastfeed often and long, until the mother’s milk supply becomes more plentiful.

Frequent and unrestricted breastfeeding in the early days offers health benefits for both mother and baby.

-Provides the baby with the colostrum he needs
-Prevents painful engorgement in the mother
-Stimulates uterine contractions in the mother and lessens the chances of hemorrhage
-Prevents newborn jaundice
-Stimulates the mother’s milk to increase more quickly

Babies should nurse 8-12 times in a 24 hour period.  Watch for your baby’s cues that he is hungry and don’t worry about the length of time since the last feeding.   Most babies will fall into their own pattern of nursing.  Some will space them evenly and some will nurse more often at certain times of the day and less at others.   It is the overall amount in a 24 hour period that is important.

One or two wet diapers a day are normal for the exclusively breastfed baby during the first two days after birth.  By day five, there should be 5-6 wet diapers per day.

The baby’s first bowel movement, meconium, is dark and tarry.  After the first few days, bowel movements should be a “golden mustard” color with “seeds” in it.  Their is usually no odor associated with the bowel movements of an exclusively breastfed baby.

When breastfeeding is going well, water or formula  supplements are not needed.  There are several reasons that supplements should be avoided.

-Supplements fill up the baby, making him less interested in breastfeeding
-Artificial nipples can weaken a baby’s suck or cause the baby to refuse the breast
-Supplements decrease the time at the breast which can lead to engorgement
-Supplements interfere with the establishment of the milk supply
Allow the baby to finish the first breast before offering the second.