Breastfeeding info and support, the La Leche League way, from how to tell when your baby’s hungry to ways to know he’s latching on correctly.
What is La Leche League?
The La Leche League (LLL) is an organisation founded in America back in 1956 by seven mums who breastfed their own babies and wanted to help other women do the same. Over the years it's grown into a worldwide organisation with 3,000 groups in over 60 countries, providing info and mum-to-mum support and encouragement to women who want to breastfeed.
LLL Leaders are mum who have themselves breastfed for 12 months or longer and undertaken extensive training to provide telephone counselling, email support and run regular local group meetings. In the UK there are 250 leaders and 77 groups in total. You can call the helpline on 0845 120 2918 or visit the La Leche League website.
Anna Burbidge, chair of the LLL council of directors and a UK leader for 28 years, says, “La Leche approach is very much about listening to what your baby wants, and feeling what's right for you. For example, it's not about trying to get into a routine if you don't want to.
“We try not to give advice, instead we think of each mother and baby as unique and each family situation as unique. What works for one person won't work for another. The basis of what we do is share information that other mothers have found useful.
“Some people think if they come along to a LLL meeting, it means you need to breastfeed for years or be an earth mother, but we're not like that at all. We very much support mums in listening to what's right for her baby and doing what's right for both of them.
“LLL believes breastfeeding is about so much more than just getting food into a baby. It's about nurturing, and laying down securities for the baby, and research shows it can even affect brain growth.” Getting the right info and support in the early days can make a lot of difference to your breastfeeding success. Attending a breastfeeding group for support before your baby is born, such as the meetings held by La Leche League, can help you prepare.
When can you start breastfeeding?
The good news is that straight after you give birth, your breasts will already be making milk. In fact, your breasts start to produce the early milk – colostrum - during pregnancy. Your baby will probably be interested in breastfeeding within the very first hour after birth.
After the delivery, lay your baby against you, skin-to-skin without any clothing or blankets between you, as soon as you can, ideally before any washing or weighing. You can ask your midwife and/or partner to help you. Spending time skin-to-skin has been shown to help a baby breastfeed. It helps to trigger a baby's natural feeding reflexes and prompt him to seek out the breast and latch on effectively.
A healthy full-term baby is likely to know what to do instinctively. Try letting your baby lie on your body as you lie back, so his chest and tummy are against you in what is known as the ‘biological nurturing’ position. In this position, even a sleepy baby can latch on.
Some babies are still sleepy from the effects of pain relief used during labour, or they may have a headache from a forceps delivery and may not want to feed. Even if you've had drugs during your labour (including because you’ve had a c-section), you can still cuddle your baby and get to know him.
Breastfeeding is normal and natural but it’s an art that may take both you and your baby time and practice to learn.
What is colostrum?
This is the concentrated milk you produce in the first few days after delivery. It is rich in antibodies and has antibacterial properties to help protect your baby against infection. It also helps to clear meconium (your baby’s first poos) and reduce jaundice. Your milk production increases around three to four days after birth, and your breasts will start to feel fuller.
How can you tell if your baby is hungry?
Signs your newborn wants to be fed include making 'rooting' movements – turning his head, sucking his fists, fidgeting or wriggling. Crying is often a later sign of hunger, so offer a breastfeed while he is still calm, if that's possible.
How often should you breastfeed?
The first time your newborn baby feeds, he generally only takes in a teaspoon of milk (colostrum).
Your one-day-old baby only has a stomach the size of a small marble, and takes around 5-7ml per feed. As your newborn baby only has a tiny tummy, he can't wait long for food. In the early days, expect your newborn to feed at least eight to 12 times in a 24-hour period - around every two hours. These small frequent feeds ensure that your baby gets all the milk he requires.
Let your baby breastfeed for as long and often as he seems interested. Let him finish feeding from the first breast before offering the second.
Is it okay for your baby to be feeding all the time?
Yes, the more you nurse, the more your breasts will be stimulated and the more milk you will make. LLL Leader Anna Burbidge explains, “Research shows that if a baby nurses a lot in the early days, it primes the breast for knowing how much milk it needs to make, and lays down the foundation for good milk production.”
Don't worry if your baby wants to feed frequently, as this is normal – and forget anything you've heard about four-hourly intervals. “The four-hourly feed way of thinking really started after women first began to use formula, but were bottlefeeding babies in the same way they breastfed,” says Anna. “This meant babies were being overfed, so doctors brought in the four-hour rule to regulate bottlefeeding. Unfortunately, it's meant some people feel if a baby is breastfeeding a lot then something is wrong, when actually we believe it's very natural for babies to want to breastfeed a lot, especially when they are small.”
How you can help your baby latch on effectively
- First get comfortable and relaxed – sit or lie back with your back well supported. Use pillows and cushions if necessary to support your head, shoulders, arms or legs, but avoid using them under your baby.
- Let your breast lie at its natural level, and make sure you feel comfy.
- Bring your baby to your breast, not your breast to your baby. Don't be tempted to lift your breast and push it into your baby's mouth.
- Position your baby with his tummy along or across your body. Keep his head and body in line, with his nose opposite your nipple.
- Help your baby latch on 'nose to nipple', with his 'chin first' close to or on the breast, and his head tilted slightly back. As he latches on, his lower jaw will be tucked into your breast, well back from the base of your nipple, with his nose free, so he can take in a really big mouthful of breast tissue.
- Try pulling your baby’s body in close to you as he attaches.
How do you know if your baby has latched on correctly?
Spending a lot of time at the breast doesn't automatically mean your baby is getting lots of milk if he isn't well-attached.
Anna says, “If your baby is making little clicking noises, often it means that your baby is not attached properly, and the nipple isn't sealed. The baby may be just nipple sucking, and not getting anything from the surrounding areola, and milk ducts.” Your baby may just be sucking on the nipple instead of taking a big mouthful of breast. A shallow latch like this means it will make it difficult to get enough milk, and he may make you sore.
Signs your baby has attached well and is getting milk include:
- Swallowing movements – frequent at the start of a feed, and less so towards the end. Also listen out for swallowing sounds.
- Your baby’s nose and chin are in contact with the breast.
- Both your baby’s top and bottom lip are protruding outwards.
- Your baby's cheeks are full and round – if your baby's cheeks appear dimpled when he sucks, it may mean there is too much unfilled space in this mouth.
- Breastfeeding is comfortable for you, with no pain.
- Your nipple is symmetrical, not misshapen, when it comes out of your baby's mouth.
How do you know your baby’s getting enough breast milk?
A baby who is getting enough milk will look satisfied after a feed, will be gaining weight and producing wet and dirty nappies. It’s common for babies to protest when put down – this is not necessarily a sign they are hungry – rather it’s a sign of attachment and a strong survival instinct.
In the first three days after birth, you’ll still see the thick, sticky, black meconium poos. After this stage, your baby should have at least six wet nappies a day, and pass at least two loose yellow stools a day.
Newborns often lose up to 7% of their birth weight in the first few days. Once your milk production increases, usually on day 3 or 4, expect your baby to regain weight. Most babies reach their birth weight again by day 10 to 14.
Anna says, “One thing that is sometimes used against breastfeeding is that fact you don't know how much a baby is getting. But actually that's quite a positive thing. None of us eat the same at every meal, and none of us is hungry exactly the same each day. Babies are the same, and with breast milk a baby can take what he wants as the breasts never really empty. A hormone in the breast kicks in when the baby starts to suck, and tells it to release more milk.”
How do you know you’re producing enough breast milk?
Even if your breasts feel empty, there's milk in there. Full breasts and engorgement actually slow down milk production and are a sign you may need to nurse more frequently. Also remember that every baby has his own individual feeding pattern.
Night feeds will help you establish and maintain your milk supply and help you avoid engorgement, blocked ducts and mastitis. Keep your baby close by to make feeding at night easier, and practice different positions such as lying down on the bed, body-to-body.
Do you need to time each breastfeed?
No, there is no need to time each breastfeed. You'll know when your baby’s had enough, by him letting go or falling asleep. Allow your baby to come off the breast when he is ready. “There is no need to feed for a specific amount of time. Watch your baby’s pattern of swallowing – fast a first, then gradually slowing as the feed progresses. This will help you judge whether he has had enough,” explains La Leche League Leader Anna.
“Babies do generally do come off on their own,” adds Anna. “However, some babies carry on sucking for comfort.”
Do you need to switch breasts?
Offering the other breast after finishing feeding on one side can help ensure a plentiful milk supply. Anna says, “It can be useful to switch breasts, especially to start with. Watch for a pattern before switching – once the swallowing movements start to trail away, and your baby possibly starts gets sleepy, it can be useful to change sides.
“If you're not feeding on both sides, and you're doing two-hourly feeds, it can mean you're not feeding on one side for four hours, so you're not giving the message for your breasts to make milk.
“Sometimes if a woman really wants to kick-start milk production, we might even say swap three times so they keep getting the milk 'letdown'.”
But whether you switch breasts is very much an individual thing. Anna says, “If a baby is very fussy, and wants to suck but doesn't need milk, it can help to put them back on the same side because then they don't need the same volume of milk.” Then he can enjoy the comfort of sucking without taking lots more milk.
Sometimes your baby will want one breast, at other times more, so stay alert to what he wants.
How can you get your baby to come off the breast?
“If you are starting to feel uncomfortable, or the baby has slipped in position, then the way to get your baby to come off is to put your little finger in the side of the mouth, between gums, and release the suction that way. Never ever just try and pull them off,” says Anna.
How can you increase your milk supply?
Breastfeed as often as you can – at least 10 times in 24 hours - and wake your baby up if you need to. Instead of feeding at set intervals, try 'cluster nursing', where you breastfeed very often at a time when your baby is willing to – often the evening is a good time for this.
What if you think your baby isn't getting enough milk?
If your baby is not gaining weight as quickly as expected (based on growth charts), then you may need to supplement his intake temporarily. Expressing milk is a good way to both supplement your baby's feeds and also increase your milk production – there are lots of different breast pumps on the market, including electric pumps and hand pumps. Remember to sterilise or wash them according to instructions.
The La Leche League feels expressing should always be the first step to supplementing your baby’s intake. If your milk production lags behind what your baby needs, then formula may be needed to make up the difference until continued expressing helps milk production catch up. In this situation it’s important to seek skilled help to assess whether your baby’s latch-on could be improved.
Avoid bottles if possible – try using a cup, spoon or syringe to feed your baby. Try feeding in close skin-to-skin contact to encourage breastfeeding.
Breastfeeding is hurting – is that normal?
“A bit of soreness may be normal, but in general, if it's hurting a lot, that means something isn't right,” explains Anna, “Sometimes a very small change in position can make all the difference.”
To avoid nipple soreness, try:
- Breaking suction before you take your baby off the breast
- Offering the least sore breast first
- Using only plain water when you wash
- Getting your baby comfortably latched on
If you do have sore nipples, nurse your baby before he’s very hungry and offer the least sore breast first.
You should always seek skilled help if feeding is painful. Once your baby’s attachment is improved the pain usually settles down.
Could pain mean something more serious?
Redness, a sore spot or lump may indicate a blocked duct. If a blocked duct doesn't clear it can become swollen and inflamed. The duct can also become infected, and this can cause flu-like symptoms such as fever, chills and high temperature. This can mean you have mastitis.
It's a good idea to promptly treat any engorgement (when the breast feels hard, heavy, sensitive and full) to avoid mastitis developing. Applying cold cloths or cabbage leaves between feeds will help reduce swelling. Also try a warm compress before feeding to help with milk flow. Expressing milk will also help to soften your breasts.
Trying different nursing positions can help to drain the area of the breast where there is a blockage – but check your baby is well-attached in the new position.
Continue to breastfeed your baby eight to 12 times a day (including at night) to leave your breasts feeling soft and comfortable, and avoid becoming overfull.
If it's not too painful, try gentle massaging of your breast – start massaging the tender spot with your palm and fingers using a circular motion to help clear any blockage.
Always seek help if you’re finding feeding hard, painful or uncomfortable and seek medical help if you’re feeling unwell.
When to stop breastfeeding
The World Health Organisation (WHO) recommends mums breastfeed exclusively for the first six months of a baby’s life, to achieve optimal growth, development and health, then continue for up to another two years and beyond, alongside foods.
The right time to stop for one baby and mum may be different for another. As Anna explains, “It's about listening to your baby, but also to yourself. We believe the ideal time for breastfeeding to stop is when both the mother and baby feel it's come to a natural end. We wouldn't ever put an age on that. No one expects different babies to walk or talk at exactly the same time, or to come out of nappies at the same time. It's the same with breastfeeding - some children do have a need to go on for longer. If you do get to point where you have had enough, there are suggestions we can offer to gently help wean a baby off breastfeeding.”
